I am an IBCLC (International Board Certified Lactation Consultant) in private practice in Northern Ireland and a La Leche League Leader with La Leche League of Ireland
Breastfeeding & Normal Baby Behaviours in an Abnormal Society
If you have breastfed, or are breastfeeding -what did you find most difficult about breastfeeding your baby? For many of us it's often not the "technical" side of breastfeeding, by that I mean getting a painfree, comfortable feed where the baby transfers sufficient milk. Of course lots of us struggle with that in the very early days but once we have resolved those issues it's not really the actual breastfeeding that most of us find difficult. It's the other bits. It's the frequent feeding, the fact that our baby wants to always be in our arms, that they don't want to sleep alone, and that often it's that they want to be at the breast everytime they are in our arms and are near our breast. Why is it that we struggle with that? Well, usually it's because the Western society that we live in tells us that our baby is behaving in a way that isn't desirable. Society tells us that our babies should feed infrequently. They should sleep alone for several hours between feeds. They shouldn't need us all that much. We should get back to our lives quickly and the baby shouldn't inconvenience us.
So what I thought I might explore today is: what are normal behaviours? What should we expect babies to do? What do babies need from us..... and crucially, why does society have such a different view of what are normal behaviours? What has happened to create the mismatch and what effect does that mismatch have on us?
What is normal behaviour for babies?
Our babies need a lot of care. In order to understand how much, I need you to suspend all your current beliefs about babies and about parents. Put everything that society has told you on hold, and think about our babies as you would look at another species - in a curious and perhaps not terribly knowledgeable way.
The first thing to understand is that our babies are born with very small brains, and are not capable of doing much to look after themselves or keep themselves safe. Other mammals that you may have seen giving birth (cows, horses, sheep, goats, pigs etc) have babies who are able to get to their feet very quickly and follow their mother around. They can flee from predators. They can find their way to their mother if they are separated and can feed. An ape can give birth and that baby is able to cling to her mother, venture away and back but spends most of her time attached to her mother, clinging to her fur. Our babies can't do any of these things. At birth an ape's brain is about 50% the size of an adult ape brain. A human baby however has a brain which is only about 25% of it's adult brain mass. Our babies cannot venture from us and return. They can't get away from danger. They can't make their way to us if they need to feed or to have some other need met. This means they are entirely dependent upon us for everything. This also means that babies need an awful lot of time, attention and labour. They take a lot of energy resources from the mother.
Why would evolution / nature design our babies to be so helpless and to need so much energy and labour from the parent? The answer lies in our pelvis. If we were going to let our babies brains grow to 50% of their adult size they would have a much bigger head. Since we birth that head through our pelvis that would mean we would need to have a much larger pelvis. A larger pelvis is heavy... too heavy to walk upright. An ape can pass a much larger head through their heavy pelvis because they walk on 4 limbs, but an animal who walks on only 2 legs has to have a much smaller and lighter pelvis, and therefore can only give birth to a smaller brain. At some stage in the past, we as a species made an unconscious evolutionary decision about walking upright. As an evolutionary trade-off for the advantage of being bi-pedal our baby's gestation changed. Rather than having a gestation completely inside the womb (like a calf for example) we created a situation where we split a baby's gestation into 2 parts. Part of it inside the womb, and part of it as an exterogestate, outside the womb but in our arms. A baby is much like a kangaroo joey. A joey is born, makes it's way to the pouch, climbs inside, drinks milk and completes gestation. Our babies are born, are placed in our arms, at the breast and are designed to drink milk and complete gestation there. Our arms are our pouch.
Those small, immature brains aren't very good at regulating the body yet. As mature adults we can keep our heart rates stable, we can bring our breathing under voluntary control, we manage our temperature. We can look out for threats. We can recognise our emotions (usually) and we have learned to manage our stress and our emotional responses to some degree. Our babies - not yet. They aren't even very good at the basic things, like stable regular breathing, heart rate or temperature unless they are on an adult body. When on an adult body, that adult keeps their body systems regulated, so babies literally need our bodies. They need their body to be against ours.
When babies are separated from us, even by a couple of feet, their bodies become dysregulated. They become stressed. They move into a fight or flight state, and once they do that, they are releasing stress hormones, and they are not releasing growth hormone. Once they are picked up again, they become regulated, they calm and they begin releasing growth hormone again.
The science behind reproductive biology is that all of a mother’s body sensations help control all of the different
parts of the physiology of the baby (Hofer 2005); this is called regulation...
Babies cry [when they are set down] because of the absence of the maternal sensory regulators: they are experiencing
dysregulation (Christensson et al. 1995; Hofer 2005). This shuts off the baby’s growth hormone and switches on
cortisol (Hofer 2005). Cortisol diverts all the calories and other neurological resources to ensuring survival, so that
homeostasis is re-established, but at the cost of growth....
When the mother provides regulation through her own body, all of the baby’s energy is available for development.
Nils Bergman, 2014
This means it is completely normal for a young baby to want to be in your arms ALL the time. ALL the time. In order to feel safe, secure and to be growing optimally, they need to be on an mature adult nervous system in order to regulate theirs. This is why people talk about the 4th trimester. It's the period of exterogestation when the baby does the final growth. The body has developed enough to survive outside of the immediate needs for the womb, placenta and amniotic fluid, but now they need the proximity of a regulating nervous system. It won't always be this way, but it is at the start.
How many of us have found that our babies wake as soon as they are put down in the cot? Google tells us to put something warm on the sheet so the baby thinks they are still in your arms, or swaddle them so they feel like they are being held, or maybe use womb sounds, or perhaps shush your baby, or maybe we need to ignore them so they learn to sleep alone? What if I told you that babies only "sleep" when they are on an adult's body? That may sound like an odd thing to say, but a young baby's sleep is very different when they are on or off a body. If you've struggled with this, no doubt you've done some googling and may have learned about sleep cycles. Sleep cycles are cycles of brainwave patterns that we go through when we sleep, from light sleep through to deep sleep, then back up through light sleep, REM, brief awakening and then back to sleep again for another cycle. This cycling is part of the process of memory formation and every step is required to form memories in the brain. The cycling is how we wire the connections in this little immature brain and how we grow it to complete the exterogestation process.
The swaddled and separated baby lies still with its eyes closed, and is believed to be sleeping. A study on autonomic
activation (Morgan et al. 2011), showed that quiet sleep was reduced by 86% in separated babies and their sleep cycling
was almost abolished.
Nils Bergman 2014
Babies don't wake when we put them down because the cot is too cold. They wake because the adult body is no longer regulating and stabilising their body, and so their body doesn't work properly.
We all know that there is a very clear link between our nervous system and our digestion. We talk about how we have butterflies in our tummy if we are nervous. We talk about the effect fear has on the bowels or on feelings of nausea. We've talked above about how babies feel stress if they are not on an adult. Is it any surprise then that babies who are not in arms for a lot of the day might have problems with digestion - gas, colic, reflux symptoms?
Then there is normal feeding frequency to consider. A newborn is designed to feed frequently. At birth a newborn's stomach is about 30ml capacity. When milk comes in, the volume of milk in one letdown /milk ejection is also around 30 ml. This means that a baby is likely designed to feed very small amounts very frequently. At 1 week old for example that could mean that a baby feeds 18 times a day. Thats approximately every 90 mins.
Normal Physiological Behaviour
Holding / Carrying
|Some carrying, but babies shouldn't need it constantly. Should not be an inconvenience||Babies expect to be in arms all the time. When not in arms body functioning and growth is impaired.|
|Should sleep alone, sleep should become longer over time with an ultimate goal of sleeping through the night and not disturbing the parent so that parents can go back to getting their pre-pregnancy sleep||Babies sleep a lot over 24 hours, but expect this sleep to be on a caregiver and sleep in short bursts rather than in long stretches of several hours. Frequent wakening is protective of SIDS and helps babies to increase feeding and to grow|
|Should feed 3 hourly, should stretch to 4 hourly shortly after that and should drop night feeds as soon as possible so that parents are not inconvenienced at night and can go back to getting their pre-pregnancy sleep||Babies feed 1.5-2hrly commonly and are designed to feed small amounts frequently day and night. Digestion only works well when on a body. If fed in a non-physiologic pattern (large amounts infrequently) or left alone to digest, digestion is impaired|
Why is there a mismatch?
There isn't a mismatch in all societies. A 1978 study of a Botswana hunter gatherer society found that babies fed 3-4 times every hour. In many traditional societies babies feed frequently, are carried between feeds, and sleep with mother and breastfeed frequently during the night. This is very different to what we see in our Western Society where babies only feed once every few hours and are expected to sleep separately. Industrialisation changed society very rapidly. A mother working in a factory simply couldn't feed her child frequently -she had to work. Babies now needed to be fed on a 3-4 hrly schedule. How would those babies be kept settled between feeds, when not being held or regulated by the parent - well, one of the ways was opium! A 2015 study called Lethal Lullabies: A history of Opium Use in Babies states:
With industrialization, private use was rampant among the working class. In German-speaking countries, poppy extracts were administered in soups and pacifiers. In English-speaking countries, proprietary drugs containing opium were marketed under names such as soothers, nostrums, anodynes, cordials, preservatives, and specifics and sold at the doorstep or in grocery stores.
When babies are not held, they cry. When they are not regulated they cry. In years gone by we didn't understand why this was and so we searched for solutions to quieten babies by physically sedating them. Today many of us who haven't been taught the neuroscience still search for solutions. Maybe it's gas? Our baby perhaps has reflux? Maybe we need to raise the head of the cot? Maybe we need to black out the windows? Maybe our baby needs a bottle? Maybe our baby is allergic to the milk? Now, these things all happen and can create issues. Babies ARE gassy, light DOES affect our circadium rhythm, the way that we feed our babies DOES make a difference - but the FIRST place we need to start is regulation, because nothing works optimally without regulation.
Societies that have moved away from the biological model have always searched for solutions because we didn't understand about regulation. In the 1920s parenting experts emerged from the fairly new field of psychology. Books were written telling parents how they should rear their children. Parents were told that they were not knowledgeable enough to raise their children. There was a right way to raise a child and a wrong way. Anxiety around parenting started to increase. We can see the effect of that. The effect of these books wasn't just to increase anxiety however. How we parent affects that society a couple of generations later. Children who are parented harshly (as was recommended in the early 1900s) produce more cortisol and grow a brain which is oriented towards a harsh world. That affects society. Robin Grilles, a psychologist who studies neuro-social evolution links harsh parenting practices in the early 1900s to the 2nd world war. The parenting swing after the war to a more loving style (Dr Spock was well known), led to an era of civil rights increases and social justice.
Still though, although we parent in a more loving way now than we did in the early 1900s we continue to have a mismatch. Babies still need more from us than our society expects.
How does this mismatch affect us as new parents?
It makes us anxious! We can see that our babies are signalling that they want to be held. We can see they settle when they are held. We can see they want to sleep on us. We can see they fall asleep at the breast or when being carried and rocked. It feels instinctively good to hold and cuddle our babies..... but then there is that voice either coming through social media, or from family/friends/wider society telling us that we don't know enough and there is a right way to parent our babies. We are holding our baby but we remember that the voice tells us that we shouldn't this - we should be putting our baby down. It tells us that it doesn't matter that it feels right - and that means that we can't even trust our instincts. Wow - that's scary. It tells us that we shouldn't feed our baby to sleep, or rock them to sleep or to comfort them. Babies are "just" looking for comfort, as if comfort is something negative rather than something that is necessary for optimal growth. We are social animals. We want to fit into our society.
We live in a state of anxiety, caught in a conflict between what we can see works for our babies, and the message that we are getting from a society which is ignorant of brain development, and is a bit resistant to the information coming from neuroscientists. The neuroscience is clear - responding to our babies with love and oxytocin leads to better brain growth.
How can we cope with this mismatch?
How can we manage the mismatch? How can we manage the anxiety? Well these are a few things I think can be helpful:
1. Know that you are the expert on your baby - not a book, and not those that give you unsolicited advice. Your baby needs loved by you. The key to growing that little brain is not following a schedule / routine / book / expert. It's relationship. It's creating a loving, trusting relationship with your baby. It's ok to hold your baby. It's good to hold your baby. It floods you both with oxytocin, and that is not a bad habit, it's creating a brain oriented towards love.
2. You don't have to respond to advice to others. When people give you advice about you baby, "you should do xyz," or "I did xyz" you don't need to respond. Often what they are saying is about them. It's about them reflecting on their experience or trying to persuade you that what they did was right. This might be to make them feel better about what they did with their babies. It doesn't mean that what they did was right. You may be doing something entirely different with your baby, and that's ok, but it can feel very confronting. Sometimes it feels like we need to justify what we are doing, but that in itself is stressful. In fact we don't need to justify it if we find it stressful to justify it. Remember that parenting is evolving. We are learning more as we go. That's true as individuals, but it's also true as a society. So, we will do things differently from each other. There are other areas of life where you know more than this person who is "advising" you. If you were a teacher and this person (who has never taught) gave you advise on how to manage children in the classroom - would you listen? Or would you think, "ok, they're trying to help, they have good intentions, but I completely don't agree" If you think the latter you'd likely be a lot less stressed about the difference of opinion. It's ok to think the same about parenting your baby.
3. Ask for help. We are not designed to parent in isolation. Young babies are exterogestates. Gestating outside the womb requires babies to be held for an awful lot of hours in the day. This is exhausting. The phrase, "it takes a village to raise a child," is not a trite throwaway expression. It is true. Exterogestation is exhausting. It is overwhelming for 1 person or even for 2 people to try to meet all the needs of 1 baby. Robin Grilles (neurosocial psychologist) has stated that for most of human history (i.e. pre-history) human babies were surrounded by 4 adults. It's much easier for 4 adults to meet the needs of 1 baby. We can't expect ourselves to do it all ourselves. It's ok to ask for help. It doesn't mean that we are failing as parents. I'd say there is an argument that it shows that we are being responsive to our baby's needs.
4. Find a Social Group who support parenting responsively. This might be in person, or it might be online, but if you don't have a social group around you IRL who believe in responsive parenting, find that group elsewhere. It's important that you have people who you can run ideas past, or who can normalise baby behaviours for you and can support you when you are feeling tired and exhausted. A group who won't respond by telling you that you are creating a rod for your own back and you should do xyz - rather a group who will say, "yes it is exhausting. Tell your story, be heard, we are here for you and we get it". A group who will normalise your baby's needs when they are little and, as your baby gets older, can help you with ways to shift your parenting to gentle discipline for older children who don't just have needs, but have wants as well. Groups like La Leche League are fantastic if you are breastfeeding, or responsive parenting / attachment parenting groups if you are not breastfeeding.
5. It's about relationship - not getting it right all the time. Parenting is hard, and we are constantly coming up against things we find challenging or have never dealt with before. That's because we are complex animals with large social & intelligent brains. We have to help our babies become those complex animals with large social & intelligent brains and that requires us to put a lot of our resources into our babies. Reproduction is a costly business from a biological perspective. Since it is challenging and new we will make mistakes. We won't always get our responsive parenting right. We will make mistakes. We will do things that are not so loving and responsive at times. That's ok! It's important to know it's ok. What do we do if we make a mistake in our relationship with another adult? We take steps to repair it. We can do the same with babies. If we do something that doesn't feel good then we can repair it. It's about the relationship, not the individual things we do. We don't have to be perfect. We can't be perfect. That means it's also ok if your family who you draw on for help doesn't do things exactly the same way that we do. We can't control other relationships, just our own. It's ok for them to do things differently when they care for your baby and for you to do them your way when you do.
It's ok that our baby needs us intensely. It's ok that we feel overwhelmed by it. Both of those things are true. That doesn't mean that by following a certain routine / schedule / social rule you will stop your baby's needs. In fact it's likely it will just make us more anxious. The needs won't stop because they are physiological and psychological. Responding as best we can, as much as we can will help our baby grow and thrive as well as making for a less anxious, more calm household and with every brain that we orientate towards love, we drive societal change. We will make it easier for our babies to responsively parent our grandchildren.
1. Bergman, N.J., 2014, ‘The neuroscience of birth – and the case for Zero Separation’, Curationis 37(2), Art. #1440,4 page. http://dx.doi.org/10.4102/curationis.v37i2.1440
3. Konner M. Nursing frequency and birth spacing in Kung hunter-gatherers. IPPF Med Bull. 1978;15(2):1-3.
4. Obladen, Michael. (2015). Lethal Lullabies: A History of Opium Use in Infants. Journal of human lactation : official journal of International Lactation Consultant Association. 32. 10.1177/0890334415594615.