The Wild World of Breastfeeding

The first and most primal task for a mother is feeding her baby. There are a ton of benefits associated with breastfeeding over bottle feeding—although it often seems that people assert causation where we may only be seeing correlation. That is, while it may be true that breastfed babies tend to score higher on IQ tests, is this because breastfeeding makes you smart? Or is it because children of upper class, well-educated mothers are more likely to be breastfed, while lower-class children are more likely to receive formula, and the former group scores higher on IQ tests regardless of early feeding methods? I’m skeptical of the more extreme pro-breastfeeding propaganda, but I am convinced that, in general, the best food for a human baby is human milk.

The problem is that breastfeeding can be really hard. I had a terrible time getting Robin to latch on in the first two days of his life. In fact, it seems like most women have some difficulty with breastfeeding at first. It really does make you wonder how the human race survived the Stone Age. Fortunately, now we have breastfeeding classes, lactation consultants, and a dizzying array of technology to throw at the problem.

Robin would suck for a bit, then toss his head in frustration, spit out the nipple, and bawl. The emotional charge was pretty enormous. My baby was rejecting me. The nurses were all watching and judging. They had forms where they took notes about me and my breastfeeding, and these forms included a scale, on which I was told I ranked “average to below average.” Specifically at breastfeeding, but I very much felt like a below average mother.

Robin lost weight quickly those first few days—all babies lose weight at first, but the magic figure is ten percent: once they lose more than that, the pediatrician starts keeping a very close eye on things. Robin lost ten point nine percent of his birth weight by day three.

The nicest of our nurses set me up with a lactation consultant. I call Dina the nicest of our nurses because, although many of them were very very nice, she gave me the best compliment: “I always like coming in here,” she told me, “because you have a very good energy, an energy of togetherness.”

The lactation consultant was named Yvonne. She was splendid. She told me the problem would most likely resolve itself once my milk came in: in the early days a mother produces a yellow liquid called colostrum, which is very good for the newborn but is much thicker than the later milk, and therefore harder for the infant to extract by sucking. Robin just didn’t have the patience, and the hungrier he got, the sooner he degenerated into angry screaming. He was clearly starting to associate the whole experience of nursing with frustration and unhappiness. So Yvonne suggested I use a breast pump to get the colostrum out, and supplement with formula until my milk supply was established. We snagged a soup spoon out of the hospital pantry to feed him with: babies that small only swallow a teaspoon or so at each feeding, and using a bottle can screw up breastfeeding even more as the infant gets used to the artificial nipple instead of the real one. (Dina later gave us a little cup to use instead.)

So Day Three was pretty wild, what with me hooking myself up to the milking machine every few hours to extract the precious, precious drops of golden colostrum. The hospital-grade electric breastpump had two big suckers that attached to my boobs, and while it was going I could watch my nipples pistoning back and forth inside the plastic tubing. It was artificial and alienating and also painful, and I didn’t feel any better about my failure to nurse my son, but at least I knew he was getting something to eat.

The next morning Yvonne was back with a little gizmo she told me was called a “nipple shield.” Nina commented that it sounds like something Wonder Woman would wear: “a gift from the Amazon queen!” It’s actually just a thin bit of nipple-shaped silicone that you can slap on over your boob. It’s a little longer than a real nipple, so easier for a baby to latch on to, and it has holes in the end of it so that the kid can suck milk through the shield, from your breast. “I think this might solve your problem,” she said, and she was entirely correct. The magic nipple shield worked like a charm; Robin latched right on and suckled happily. It was incredibly, incredibly rewarding to finally be able to hold and feed him normally, to feel him curled up close to my body and to know that now, for him, I’d be a locus of pleasure and contentment rather than hunger and frustration.

The day after we came home my milk came in, and just as Yvonne predicted, Robin’s now able to nurse without the shield. I still use it sometimes when we’re having trouble getting a good latch, usually because he’s slept too long between feedings and he wakes up hungry and impatient. But most of the time it’s just him and me, unaugmented. He’s gaining weight again now and the pediatrician is happy.

My days and nights now revolve around feedings. Every one and a half to three hours, day or night, I know I’m going to be obliged to sit down with Robin for about an hour, sometimes more and sometimes less, depending on how long it’s been since the last feeding and how long it takes him to latch on. As I’m writing this I’m calculating in my head how long I have until he wakes up hungry. (Probably not very long.) But the nursing itself is sweet and lovely and I’m terribly grateful that it’s working out for us.

9 Responses to “The Wild World of Breastfeeding”

  • Nina Says:

    futhermore, I feel as if the nipple shield should be gold.

    glad you two are making headway. boobway?

  • Madeline Says:

    I’m so happy to hear that your milk has come in, and that nursing is working out. That’s great news!!!

    The first few months, I couldn’t believe how much time I spent nursing. I think it came out to about 8-10 hours a day at first, when I added it all up. My favorite nursing accessories were a Boppy; a backjack, so I could sit up in bed at night to nurse, and plop down comfortably anywhere on the floor to nurse during the day; and a hands-free nursing contraption, such as a sling, or an Ergo with an infant insert, especially for sitting at the computer while nursing.

    I’m pretty sure there’ve been studies that have controlled for socioeconomic status with nursing, and still found that formula-fed babies lose a few IQ points. I think the coolest benefit of nursing, though, is that the baby gets your immunities–from vaccines you’ve had previously, and from any cold the two of you are both exposed to. Ibby and I caught quite a few colds during her first full winter, but she got only very mildly sick each time.

  • Madeline Says:

    Also, I agree that it’s weird how hard it often is to nurse at first. I think those Stone-Age babies probably had a hard time at first, too, but since their options were nurse or starve, they probably figured it out pretty fast.

    Plus, maybe first-time nursing was easier for Stone-Age women, since they probably saw their mothers, sisters, and friends nursing their babies all the time, topless, and for several years per child. That sort of direct exposure is probably more useful than all the lactation consultants in the world.

    Not that I’d like to go back to the Stone Age. I read recently that childbirth has become the leading cause of death for young women in Afghanistan, and that 1 in 7 women there now dies in childbirth. Thank goodness we got rid of the Taliban, so that the women of Afghanistan would have human rights…

  • Wendy Says:

    I’m so glad you guys are hitting your stride with nursing. Wyatt and I had a very hard time at first too (like all new nursers, it seems). For the first two weeks or so he wouldn’t open his mouth far enough to latch properly and even after he got it right I recall toe-curling pain when he latched on for the next couple of weeks. After a while you guys will be so good at nursing it will be funny. We have pictures of Wyatt standing on the arm of the rocker while he nursed when he was about 11 months old. He danced and wriggled around so much I was afraid he’d fall off our chair.

  • Nina Says:


    The IQ connection has been pretty well debunked, with a large study (3000 moms, 5000 kids, BMJ Oct 2006, finding a difference of less than one half of one point between breast- and formula-fed kids, after appropriate regression analysis (mostly with regard to parental IQ, which alone accounts for 75% of the reported difference, and environment).

    Which doesn’t mean that breastfeeding isn’t a really cool thing (making food out of your body, how great is that?), or that it doesn’t have other health benefits, but IQ is probably not one of them.

    Back to the cave-baby point, I wonder if it was common for an already-lactating woman to help with the breast feeding? Maybe then the baby could learn the latch, and the new mom could watch. Although nipples are so different, maybe that wouldn’t work. Now I’m imagining a Flintstones-style nipple shield.

  • Madeline Says:

    Thanks for the link, Nina. It’s a very authoritative study. Here’s another viewpoint, from neuroscientist Lise Eliot’s book What’s Going on In There: How the Brain and Mind Develop in the First Five Years of Life (Shannon, this book is a very fun read for a new mom, by the way–written for a lay audience but very intelligent and detailed, and loaded with cool facts about infant brain development, like the fact that babies develop binocular vision suddenly, often overnight, and the fact that human infants raised in tents grow up better able to perceive diagonal lines, while those raised in houses have an eye for horizontal and perpendicular lines).

    Anyhow, here’s what Eliot has to say (forgive the long quote–I couldn’t find a link to the full text online). The last three paragraphs raise some really interesting points:

    In dozens of studies, breast-fed children have been found to hold a significant cognitive advantage over formula-fed children; they score higher on tests of mental development (such as language, social, fine motor, and object response skills) between one and two years of age, on various intelligence tests during the preschool years, and on scholastic achievement tests as late as ten years of age. Many studies, moreover, have looked at the duration of breast-feeding and found that the longer babies are breast-fed during their first year, and the less formula supplementation they receive, the higher their IQ or academic achievement tends to be.

    No one disputes the association between breast-feeding and intelligence. The problem, however, is in figuring out the reason for it, because breast-fed children differ from bottle-fed children in several other ways known to predict cognitive achievement… [B]reast-fed children may be smarter simply because they come from more advantaged homes, have smarter parents, or–given the difficulty and degree of sacrifice involved in breast-feeding for many women–have “better” parents, on average, than bottle-fed children.

    Researchers are well aware of these sociological differences and have attempted to compensate for them in virtually all studies. In most cases, they do so through statistical corrections, adjusting children’s test scores to take account of their parents’ education, socioeconomic status, the mother’s IQ and her cigarette and drug use, and so on. Even after factoring out such “covariates,” however, most studies find significant cognitive differences between breast- and bottle-fed babies, although the size of the difference is reduced.

    One 1992 British study took another approach to circumvent this problem. These researchers studied the cognitive development of two groups of premature babies, whose mothers were of similar educational and socioeconomic standing and all of whom had intended to breast-feed. Because pre-term infants are often too weak or undeveloped to nurse when they’re born, they must receive their nutrition through a stomach tube. “Breast”-feeding therefore requires that mothers express their milk several times a day, which is a very difficult way to initiate and maintain lactation. In spite of their attempts, not all mothers in this study were successful, so some babies received their mother’s milk while others received formula through the tube. (This feeding method eliminates the possibility that some difference in nursing style between bottle- and breast-feeding, such as the degree of physical contact, could affect cognitive development.)

    The results were striking. IQ tests some eight years later showed that children who had received breast milk were significantly smarter, scoring over eight points higher than the children who had been fed formula. It is still possible that these two groups of mothers differed in some other unrecognized way that might underlie the children’s cognitive differences. But in another preliminary study, the same researchers found that preterm babies reared entirely on *donor* breast milk–that is, whose own mothers had never even intended to nurse them–were more developmentally advanced at eighteen months than preterm babies reared on a standard infant formula.

    …[I]t is interesting to note that some of the first studies of breast-feeding and cognition date back to the early twentieth century, when the tables were turned and only the more affluent, educated classes could afford to bottle-feed. Even so, breast-fed babies developed better.

    Whew! Having quoted all that, I certainly don’t think IQ is the most real or important thing in the world, or the primary reason to try breastfeeding. And, of course, I know plenty of highly intelligent, well-adjusted people who were bottle-fed.

  • Nina Says:

    That’s fascinating about the tents vs houses (and solidifies my plan to raise my children in a geodesic dome. or maybe a yurt.) Sounds like a fun book.

    It’s certainly possible that although no significant effect has been shown for full-term babies, there may be some effect for preterm babies (who were excluded from the newer study).

    I just always have to invoke the highest standards of evidence regarding the One Best Way to birth/feed/raise a child — especially when the One Best Way is simply not going to be available to some people.

    It all reminds me so much of the medicated vs unmedicated birth debated, or day care vs no day care… standards change, advice changes, best practices change, and mothers still do pretty much what they have always done: the best they can. And humanity muddles through.

  • Jessie Says:

    I don’t think I know ANYONE who had no trouble breastfeeding. Not that I know a lot of lactators, but all the ones I do have had lots of problems with it.

    I’ve heard that it’s hard to breastfeed if you have large areolas, because the milk comes from all over the areola, not just the nipple, and a baby just can’t get its mouth over the whole thing. Of course I have no way of knowing whether the average areola size now is greater than it was in the Stone Age, but what with better nutrition and environmental estrogens etc., I wouldn’t be surprised.

  • shannon Says:

    I have large aureolas, but the milk definitely comes from just the nipple. It pools up *behind* the aureola (inside the breast), so it’s important to get some of the aureola into the baby’s mouth along with the nipple, because the action of the baby’s mouth against the aureola will stimulate the milk to flow. But it comes out through the nipple. There’s actually no chance of Robin fitting my whole aureola in his mouth, but that’s okay–he just needs to get a good mouthful, and he’s gotten pretty adept at that.

    There are also glands called Montgomery glands around the aureola which emit some oil that seems to help in the whole breastfeeding process. It’s a pretty small amount though, and it’s separate from the milk itself.

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