How Did The Human Race Ever Survive?

Breastfeeding is supposedly the most natural thing in the world, but for so many moms it can be a difficult new skill that they are expected to learn with very little support. To mark Breastfeeding Awareness Month, certified breastfeeding specialist Annie Seymour, looks at how we can ensure that breastfeeding is successful, despite all the odds.

By Annie Seymour

It’s the question I’m most often asked during a breastfeeding consult.

“How?” moms ask, as they frown over breastfeeding apps and adjust their Haakaa pump, “HOW did the human race ever survive?!”

I understand the question. But let’s try a different one:

Having thrived for millennia, why do so many women now fear they are not capable of feeding their babies?

Humanity has survived because we’re extraordinarily well designed to do so. Breastfeeding works: it’s what breasts were designed to do, and we’ve covered the planet because of it. Yet right now we live in a society where parents are pressured to breastfeed, but set up to fail.

As we mark Breastfeeding Awareness Month, the thing I’d most like to raise awareness about is the context in which we are nursing. This matters to me because I become so sad when moms tell me they’ll “try to breastfeed”, but have heard that it’s “really hard”, or unwittingly make decisions that play directly into the obstacles against them, or only see their struggles instead of their incredible love and resilience.

Of course, millions of mothers breastfeed happily, fully, nourishingly, every day, with no problems at all. However, many experience challenges, especially in the beginning. These are very seldom due to anatomy or physiology, and innate challenges are rare. Instead, a tangle of structural and social obstacles create issues that families should never have to face.

For many of us, breastfeeding is alien from anything we’ve ever done. Yet we hear that it’s the most natural thing in the world and we’re expected to simply be able to do it from the get-go. As with all new skills, there’s a learning curve as you find your feet. Breastfeeding takes perseverance. It’s messy, physical, repetitive, unpredictable, and sometimes sore. It’s a healthcare measure like no other in that—time-intensive, day and night—it falls largely on women alone. Given our busy lives and social structures, it can take real ingenuity and sacrifice to do it. Yes, it is natural, but we are doing something natural in highly unnatural circumstances, and we need to acknowledge that so we can better support our breastfeeding moms.

The institutions and instincts that facilitated breastfeeding throughout history have been suppressed by gadgets, Google, and self-doubt. Sleep-deprived and worried parents are turning to an industry that created the self-doubt and sells solutions; an industry that created a belief that you can’t be trusted, but that their products can.

You try to give yourself the best start. Maybe you even birth in a hospital that implements the Baby-Friendly Hospital Initiative (BFHI). Not a ‘breastfeeding friendly’ marketing claim, but the WHO/UNICEF gold-standard accreditation with ten steps to ensure hospital practices enable breastfeeding (1). 

The ten steps include ensuring staff have knowledge and skills to support breastfeeding, facilitating immediate and uninterrupted skin-to-skin contact, supporting mothers to recognize their infant’s cues for feeding, and not promoting formula without a medical reason.

Sadly, despite the commitment of some of the fantastic individuals in them, not all hospitals have international breastfeeding accreditation, meaning many women give birth in institutions which routinely practice birth interventions proven to hinder lactation.

You may not be told, for example, that the first hour is critical (2). Instead, nurses may take your newborn aside for testing, unless you specifically ask in writing to be with them. They will be returned to you swaddled up, immediately restricting their reflexes to nurse. Some hospitals even charge for skin-to-skin contact, one of the most effective ways to begin a breastfeeding relationship (3)! You have to decide if you can afford for your own baby to be placed on your own chest.

You may not be told how competent your newborn is: that for healthy term newborns, breastfeeding is the one thing they’re already experts at (4), with multiple reflexes to enable a successful latch. Modern life has largely detached us from our instincts, so you unwittingly tune out your body’s extraordinary postpartum physiological choreography for instinctively initiating nursing. You may not be shown different positions, and certainly not the laid-back position which alone can fix many early breastfeeding hiccups (5). Or you might not be shown how to hand express, which is more effective than a pump for expressing colostrum if needed (6), and can replace pumping all together for light-use expressers (No cost! No sterilizing!). 

You look for inspiration from other societies with better rates of breastfeeding to learn their tips (7), but breastfeeding is a complex social behavior and isolated practices can’t easily be transplanted from another context. Wearing your baby all day is much more feasible if those around you can take on the chores (and if people aren’t tutting—against all the evidence—that you’ll create bad habits) (8). You might rarely see other women breastfeed in public.

Indeed, perhaps you’ve never seen other women breastfeed at all. Perhaps your family and friends didn’t breastfeed, so they can’t show you how. Or they had an unnecessarily difficult time, so they tell stories that worry you without any relevance to you and your baby. They have opinions about how you should feed, because they want to help, but their advice may not be based on evidence and can set you back in your crucial early efforts to establish your supply.

So you turn to the internet, a sea of misinformation, predatory marketing, and overwhelming advice that does not apply to the unique dynamic of you and your baby. Well-meaning bloggers present personal experiences as universal truths. Forums are moderated by companies with solutions to sell. People convincingly promote their one-size-fits-all method about what time you should feed your baby with absolutely no relevance to the two of you and your unique rhythms.

The web is a wonderful source of information, but it can be a tough village for a new mom.

Without a tribe of breastfeeding women around you, you rely on your medical professionals. However, very few pediatricians have received in-depth lactation training. They may be an outstanding pediatric generalist but are very rarely also lactation specialists. And by the time you get to see the pediatrician, the support you need may exceed their scope.

So you look for that specialist. You find a practitioner who speaks your language, who will come to your home—hurrah! But your insurance won’t cover an independent practitioner and you have no guarantee it will fix the issues, so paying out of pocket is a tough decision.

And then it’s time to go back to work. You fight to protect time and space to express, but pumping in a stationery cupboard suppresses your hormones, and colleagues mutter about your ‘break privileges’. Your childcare doesn’t use paced bottle feeding, so your baby develops a bottle preference and loses interest in your breast (9). You wean to formula with a heavy heart, unable to explain to those who nod approvingly that you are grieving, that you need care.

To our fabulous breastfeeding families, present, former and aspiring, this context is what I want you to know in Breastfeeding Awareness Month.

When you are aware of it, you can make more informed decisions and advocate for what will help you and your baby. You can trust your instincts, trust your newborn. And if you ever feel that you ‘failed’, you will understand that you have been failed. Together we need to put the pressure on the barriers in our way, instead of on moms.

Let’s know this, see it in action, and rebel against it. Let’s create a society that enables our families to breastfeed and cheer them on.

Photos courtesy of Canva

References

1. UNICEF (2018) Baby-Friendly Hospital Initiative.  unicef.org/documents/baby-friendly-hospital-initiative
2. Neczypor, J. & Holley, S. (2017). Providing Evidence-Based Care During the Golden Hour. Nursing for Women's Health. 21. 462-472.
3. Moore, E.R. et al. (2016) Early skin‐to‐skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD003519. 
4. Lothian, J.A. (2005) The Birth of a Breastfeeding Baby and Mother, Journal of Perinatal Education, 2005 Winter; 14: 42–45.
5. Colson, S.D., Meek, J.H. & Hawdon, J.M. (2008) Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Department of Health Well-being and the Family, Canterbury Christ Church University.
6. Ohyama, M., Watabe, H. & Hayasaka, Y. (2010) Manual expression and electric breast pumping in the first 48 h after delivery. Pediatrics International 2010 Feb;52:39-43.
7. Oakes, K. (2021) Is the Western way of raising kids weird? BBC Future, Feb 2021.
8. Berecz, B., et al (2020) Carrying human infants – An evolutionary heritage. Infant Behavior and Development, Volume 60, August 2020.
9. La Leche League GB (2022) Bottles and other tools. laleche.org/uk/bottles-and-other-tools/.

About the Author

Annie Seymour is a Certified Breastfeeding Specialist, working with families in Bangkok. She is currently studying towards an International Board Certified Lactation Consultant (IBCLC) certification. You can find her online at annieseymour.org, at the weekly breastfeeding support group Galactamoms in Saphan Kwai, or playing diggers with her two spectacular young kids.

The views expressed in the articles in this magazine are not necessarily those of BAMBI committee members and we assume no responsibility for them or their effects. BAMBI Magazine welcomes volunteer contributors to our magazine. Please contact editor@bambiweb.org.