These archives contain posts from the UK Midwives and Consumers email list, a discussion group for people interested in midwifery in the UK. All are welcome to join the group. Posts in these archives express the views of the individual authors, and not those of the Association of Radical Midwives.
Is it necessary to rest to successfully breast feed?
No, resting *per se* has nothing to do with making enough milk, but not feeding the baby has everything to do with it! Someone who is back at university the day after giving birth in a seminar is clearly not feeding the baby. Mothers and babies need time together, time to feed, and it is this that drives the supply.
It's not 'rushing around' that makes milk inadequate. It is the 'rushing around' that prevents the mother feeding the baby often enough, responding to feeding cues and so on (or waking the baby up if it is a placid little thing who tolerates being ignored!).
I would say that milk production is not affected by lack of rest, but let-down can be affected by stress, which would mean that the feedback system whereby milk has to be removed before more milk is made isn't being stimulated.
This is controversial.....let down is certainly *temporarily* affected by major stress like severe pain, great fear or a massive trauma like a car accident or the death of someone very close to the mother. I know of no research that shows constant or frequent low level stress affects let down, and speaking teleologically, it would not be a good evolutionary adaptation for it to do so....for most of our human existence, life has been intermittently and sometimes pretty constantly stressful on a low level, so a feeding 'system' that coped with this challenge would be more likely :) But if anyone knows of any good evidence that says different, let me know.
However, I do think it's possible, but very, very rarely, for a mother not to have any milk for her baby for no apparent reason . Yet in 24 years of breastfeeding counselling I have not come across a situaton like this - while I have heard from hundreds of mothers who think this has happened to some degree, there has always been an explanation, often to do with getting off to a poor start. Some mothers can overcome a poor start if they get going again; others can't.
Heather Neil
Dear Heather,
I raised this point with you a while back. I agree with everything you say.
But I don't think a telelogical point of view can be advanced as an argument
in the context of industrialised societies.
I know of no evidence for inhibited letdown but I was a psychology student before I became a midwife and it always seemed to me that reflexes can be easily conditioned and that an inhibited letdown made sense to me as a reason why many women "could not" breast-feed. I don't think that the stress needs to be big -- just the constant anxiety of: have I got enough? Or the sexual ambiguity of breast-feeding... I think the ethos of this culture is opposed to breast-feeding and that there are often family pressures as well as the social ethos to be countered.
I think that many women need huge amounts of support in the early days and that support is not factored in to the structure as it used to be -- staff shortages on postnatal wards, reduced community midwife visits (I know that some midwives are worse than useless). I was a community midwife in a working-class area of inner London where breast-feeding was not the norm. I sometimes used to think that many of the women I visited were only breast-feeding to please me and were dying for me to discharge them so that they could stop. I think I had a breast-feeding rate of over 50% at discharge.
Midwives exist in the context of the culture and a lot of them have no real faith that breast-feeding can keep a baby alive. I remember you saying in the context of some other aspect of breast-feeding that some people regard breast versus bottle as just another lifestyle choice. I think we are both in agreement that it isn't -- that it is much more important than this physiologically, psychologically, socially and politically. I'm happy to be proved wrong on the issue the letdown, but I still think it makes psycho physical sense.
Yours, Meg (retired midwife -- sorry for the rant)
LW updated February 22, 2006