Am I the Pacifier?

Am I the Pacifier?

Breast for Comfort: 

What’s A Mom To Do?


When I was working as a lactation consultant in a hospital setting, I was asked some version of this question every time I walked into a patient’s room: 

“How do I know if my baby is nursing for comfort? I should take my baby off the breast, right?”

There are a lot of cultural assumptions built into that question that I didn’t fully realize until I had my own baby. Comfort feeding has a negative connotation in our culture, with many women being told it’s something they should avoid so they don’t coddle or overfeed their baby.  If you think about feeding your baby this way, however, it will impact your milk supply and baby’s growth and development. The fact is, saying a baby can comfort feed, or use mom as a pacifier, is a misguided cultural concept. Attempting to separate comfort feeding from the way our body establishes and maintains a milk supply is impossible; it’s not based on professional recommendations or a clear understanding of how a baby gets its nutritional and emotional needs met. 

 

This cultural assumption is not based on science. 

 


Here are a few ways to think about this topic and how it can impact your breastfeeding relationship.


Biology vs. Culture: Where to draw the line?

There’s a strong cultural push to have babies become independent as quickly as possible, even when research and infant biology tell us it’s better for them to be close to their caregiver and for caregivers to be responsive to their infant’s cues. Responsive feeding is more than just feeding; it helps infants regulate their heartbeat, breathing, digestion, and emotions. 

 

This is why the World Health Organization recommends infants to exclusively feed on demand for the first 6 months of life. Demand feeding, responsive feeding, or baby led feeding all mean the same thing; baby eats whenever baby wants, for however long baby wants. For the purpose of this article I’m going to use the term responsive feeding because it’s more in line with infant biology.  

 

Responsive feeding isn’t just for breastfed babies; it can be done with bottle fed babies as well. But, I’ll be talking about responsive feeding for breast fed babies only. 

  

Thoughts to consider as you think through responsive feeding:

How much body space do you need during the day? 

How much weight and/or meaning do you give to infant biology?

Most infants protest when separating from their mother and/or from breastfeeding; it’s important to consider how comfortable you are adapting to your baby’s needs versus asking your baby to adapt. Taking time to think through what’s important to you and evaluating the pros/cons of responsive feeding/parenting can help in guiding your decisions. 

 


Breast for Comfort: A scientific perspective

 

There are a number of research studies that demonstrate breastfeeding is MORE comforting to babies during painful procedures, like retinopathy of prematurity screening, IV placement, or vaccine administration. 

 

The duration of crying and pain response is lower when babies are breastfed compared to other comfort measures like swaddling, skin to skin contact, music therapy, topical anesthetics, oral sucrose (‘sugar water’) or even expressed breast milk given in a bottle. 

 

Breastfeeding naturally has an analgesic (pain reducing) effect on infants. 

 

The idea that the breast could be anything other than comfort is not possible because comfort is intrinsic to the design of the breast and to the experience of the infant. In addition to that, babies cue to feed for hunger, thirst, connection, or sleep. We don’t actually know which one is driving each particular feeding session. There’s no way to know if your baby is feeding for connection or hunger, particularly in the first 6 months of life. 

 

This is where science and culture get a little muddled, and where a certain social conditioning is still at play in how we discuss breastfeeding, breast for comfort and infant biology. We are getting conflicting advice on the science of breastfeeding and the culture of breastfeeding. Science says feed when baby cues; culture says get baby on a schedule with timed feeding sessions. 

 

You can thank John B. Watson, a behavioral psychologist, for that one.  In the 1920’s he led the way in teaching mothers they could give too much love to their babies and recommended strict feeding and sleeping schedules. There are still negative perceptions related to responsive parenting and feeding that tie back to these historical recommendations. 

 

If you throw sleep culture on top of it, where a majority of the sleep books recommend separating the breast from sleep, it gets even more confusing. 

 

I find the ‘separate breast from sleep’ recommendation ironic since melatonin is found at higher levels in breast milk during the night. Breastfeeding through the night can help infants fall asleep easier and reduce symptoms of colic. In fact, one study found that infants who breastfeed throughout the night feed more frequently than formula fed babies, but were awake less than formula fed babies.

 

Thoughts to consider:

What is a mom to do? Bend to biology or culture?

It’s ultimately up to you to decide how you feel about the recommendation for responsive feeding and how far to take it. I wasn’t planning on creating womb #2 (i.e breastfeeding in the baby carrier), but I ended up loving it and feeling more free and flexible during the day. However, it does limit me in other ways since my daughter refused all bottles and pacifiers. I’m on a short, cute leash, people.

I recognize some women feel a loss of body autonomy with responsive feeding and feel drained and tired from long nights; plus, it can make it very difficult to return to work.

Soap box: we need A LONGER PAID MATERNITY LEAVE!

Knowing your own needs, the benefits of responsive feeding for baby, and identifying your breastfeeding goals can help you make an informed choice about how to feed your baby. 

 

To Sum It Up:

Pros 

-Establishes a long-term milk supply. The more a baby goes to the breast (nutritive or non-nutritive) the more milk you make; supply and demand, baby!

-Helps baby gain weight. Every mom produces a different amount of milk, every baby transfers a different amount of milk, milk varies in caloric content, a baby’s stomach may vary in size. Bottom line: we don’t know how much a baby actually gets when they feed at the breast (and we don’t need to know if we follow demand feeds!). Allowing baby to determine how and when to go to the breast helps them gain the appropriate amount of weight.

-Soothes and reduces pain

-Helps babies sleep better at night (but that doesn’t mean they wake up less!)

-Promotes attachment, facilitated by the hormone oxytocin (released when breastfeeding)

-Cry less; less stress

 

Cons:

-All of these are related to maternal experience. There are, essentially, no cons to responsive feeding for a baby

-Maternal exhaustion

-Loss of body autonomy

-Possible impact on your return to work

-Difficulty weaning 

*Some women aren’t sure if frequent feedings are related to a low milk supply. If you have questions about this concern, send me a message! 

 

 

 

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