by Eva Bild, Doula and Childbirth and Breastfeeding Educator
Baby-Led Latch, Laid-Back Breastfeeding, Reclined Breastfeeding, or Biological Nurturing have become the core of my breastfeeding teaching. These techniques can be done at birth, but also weeks later. They help to spin a thread that bonds mother to baby and baby to mother. They prevent breastfeeding problems and solve them too. They help tired mothers get more rest and hungry babies get more food.
In 2005, I met Dr. Christine Smillie, a pediatrician and lactation consultant from Connecticut. She introduced me to the idea that, given time and support, babies can latch themselves. I had seen Lennart Righard and Margaret Alade’s video Delivery Self-Attachment (1990),21 but I had never seen anyone allow a baby to self-attach in real life. And I had no idea a baby could do it weeks, even months after birth. I was so excited! I had to find a mother/ baby and try this out! I went home, and I started trying Baby-Led Latch with the moms who came to me for breastfeeding support. I was amazed. I came home after consults and gushed to my family about how clever the babies were and how happy and relieved the mothers were. When we let the baby lead the way, the baby often latched on better and more easily, with much more comfort for the mom.
About five years later, I read an article in the journal of Early Human Development by Dr. Colson,22 a British midwife, about how putting the mother in a reclined position and putting the baby tummy down, on top of the mother, releases reflexes which allow the baby to find the breast and latch on most effectively. Dr. Colson (she has a PhD in Midwifery, which is why we call her “doctor”) explained in detail what Dr. Smillie had discovered by trial and error. The mother’s body is the baby’s natural habitat, and in that context, on his/ her tummy, the baby is able to use head bobbing, rooting, reaching, grasping, stepping, and placing reflexes to find the breast and latch on. So, I started to show my clients a more reclined position for nursing their babies. And every one, including the babies, breathed a sigh of relief. The mothers relaxed, they stopped craning their neck and hunching their shoulders, they were able to rest while nursing and their milk flowed better. The babies responded to their mother’s mood and relaxed too. They were able to latch on very deeply, because their heads were free to move and their mouths could open really wide. By latching on deeply, they stimulated the breast better and removed more milk, thus helping the breast to make more milk. If there was already a lot of milk and it flowed very fast (as it does for many moms), the baby dealt better with the flow when lying on top of the mom because the milk was then flowing uphill.
Some mothers asked me if starting out this way was going to mean they had to lie back and undress the baby for every feed . . . forever?! The simple answer is: no. As the baby gets older and the mother-baby pair gets more confident and competent, they can use all sorts of other positions—ones that involve mom sitting upright in what I call “Starbucks-friendly positions” (positions you can use in a coffee shop without attracting a lot of attention). There is a whole world of breastfeeding positions out there, and they are different for each mother/baby, and different for every stage of their breastfeeding career.
I began to wonder, why did I spend over ten years teaching women to sit upright and hold their baby’s head and control the latching? Where did we get the idea that this was how babies had to feed?
Books giving advice to mothers—as far back as the beginning of the 1900s—recommend sitting up to breastfeed with a “flat lap” and holding the baby to the breast with firm pressure on the upper back. Alternatively, the mother could lie on her side, again holding the baby close with pressure on the baby’s back. This was because babies were believed to prefer feeding on their backs. Albrecht Peiper, a German doctor, described throughout his work the human infant as an “obligate dorsal feeder,”23 unlike other mammalian infants—cats, dogs, rabbits—who naturally feed while lying on their bellies and are described as “ventral feeders.” Where did we get this idea?
Now I have to give a warning here. None of what I am going to say next has been proven. It is my hunch. Maybe someday, I will have the time to go and prove it to be true. But as a hunch, I think it is worth thinking about. It examines how knowledge is gained and lost, and then regained . . .
Two or three hundred years ago, in Europe (and among Europeans in North America), mothers gave birth at home, assisted by midwives who were most often mothers themselves. If there was no trained or experienced midwife available, there was likely some older woman who had seen other babies being born or had given birth herself. The new mother was encouraged to stay in bed and rest and recover for several days, if not a few weeks—the “confinement” or “lying-in.” Now of course this only applied to women who had families for support (and homes), but that was still a large majority of the childbearing women.
So the mother kept to her bed. Remember these were not firm, springy, modern mattresses—they were soft and squishy and made of straw or hay, with a layer of feather over the top, if you could afford it. And the fashion in the 1700s and 1800s was to lie on pillows, semi-reclined—not flat as we do today. (That’s why when you see those old beds in museums, they look so short. Yes, people were shorter back then, but not that much shorter). So the new mother, reclining on her bed of straw and feathers would have held her baby on her chest and she would have had lots of time to learn, and her midwife would have observed, that the baby was most comfortable nursing that way. Later, when the mother was up and out of bed and back to her work, she would have fed the baby as she sat up on a bench or a chair. But remember, older babies can feed in all sorts of positions.
Around 1920, in urban areas in Europe and North America, and the middle of the twentieth century in the countryside, women started to use the hospital to have their babies. There, they were cared for by doctors (mostly male) and by nurses or nurse-midwives (who were unmarried and not mothers themselves.) These care providers had never seen the mother-baby pair in their “natural habitat” —the mother on a soft bed of natural fibers and the baby on the mother’s soft body.
Where had the doctors and nurses of the early twentieth century learned about breastfeeding? In hospitals, where sitting upright on the firm, tightly made beds was possible? In a society where sitting up straight was a symbol of moral rectitude? In medical and nursing schools where “good posture” was considered part of good health? Probably.
I would also like to suggest that some of the images of breastfeeding these doctors and nurses had in mind were paintings. There are many, many European paintings of mothers nursing babies: a lot of them are paintings of Mary and Jesus. And almost all of those paintings depict a mother feeding an older baby. Why are they all of older babies? Because new mothers stayed in bed! They were not posing for paintings! In other words, the pictures of breastfeeding that have been handed down through the European culture are of how we feed older babies. And the nurses and doctors of the twentieth century tried to apply techniques suitable for older babies to newborns.
Mother of the Green Cushion
by Andrea Solario, 1507–1510.24
Baby John being Nursedby
Mary Cassatt, 1910.25
There has been a lot of discussion of why breastfeeding is so difficult for new mothers nowadays. Why is it so difficult for us to provide mothers with enough good breastfeeding support so that they can not only initiate breastfeeding, but also continue to feed their babies at the breast for the two years (or more) that are recommended by pretty much every health authority in the Western world (see World Health Organization26). Is it because mothers-to-be have not usually had the opportunity to witness mothers breastfeeding? Is it because the grandmothers of today often did not breastfeed themselves? Is it because our culture has lost our breastfeeding heritage? Yes.
When the process of birthing and recovering and learning to breast-feed and care for baby moved into the hospital, we lost the thread to past generations of breastfeeding mothers and grandmothers.
When I help a mother get comfy in bed with many pillows behind her, when she places her baby skin-to-skin on her chest, and I watch that baby head-lift and look up at the mom’s face, when I see the mother smile in response to her baby’s gaze and rub the baby’s back, and I see the baby start to bob on the way down to the nipple, I know that we are spinning the thread that will link this mother to her baby and to all the babies beyond.
Eva lives in Victoria with her husband. With three grown children, Eva is the owner/operator of The Mothering Touch Center, a store and education center for new and expectant parents. She is a certified doula, and a breastfeeding and childbirth educator.