the challenges of breastfeeding: there's no one right way to feed your baby

marita obst remembers the sense of comfort and love she felt while breastfeeding her children at home, taking in the moments. as a midwife in edmonton, alta., for almost a decade, helping others find their own rhythm and joy in lactation is a highlight of her work and relationship with her clients.

“i understand that feeling of middle of the night, quiet with your baby, where it’s just the two of you and your oxytocin is flowing and it’s just can be this beautiful bonding experience. i really love being able to support people in reaching the place where they get that feeling with their kids,” marita says.

intimacy, bonding of breastfeeding

“i’ve talked to so many people as a midwife where they bring it up later on in life, they talk about their birth experiences and if they breastfed their kids, they remember that intimate, cozy, incredibly bonded time. so it can be very special and it really requires a lot of support to make it that way.”

breastfeeding, chest-feeding or lactation — whichever you choose to call it — is not for everyone, she stresses. it comes with challenges and each individual should choose what’s right for them. marita is also president of the canadian association of midwivesand advocates for one of the key tenets of midwifery practice: autonomy or “informed choice.”

“it’s important for people to make the choices that are right for their body and for their babies and that extends to how they feed their babies as well,” she says. “we want them to understand the pros and cons of any particular choice they’re making for their pregnancy, their birth or as parents.”

informed choice for parent and baby

some people choose to do a combination of breastfeeding, pumping breast milk for bottle-feeding and formula. it comes down to “doing whatever honestly helps to support you mentally, physically and emotionally.”

marita says there’s no one right way to feed your baby.

the benefit of having a midwife as your primary care provider is the experience and support in prenatal, birthing and the six weeks following the birth for check-ins and home visits. “we definitely do a lot of preparatory work in the prenatal period, so teaching people about what to expect with regards to baby feeding cues, how to latch, positioning and just normalizing that this is a process and that you’ll need good community support,” she notes of reaching out to family and friends, along with support from your midwife.

breastfeeding can be ‘very difficult’

in her experience, when it comes to lactation, people assume that it’s natural, so it’s going to be easy. but that isn’t always the case. “frankly, it can be very difficult,” she says, adding that the first few days can be the most stressful because the birthing person may not have breastfed before and the baby has never done it before. there’s worry about figuring out how to get a comfortable latch and making sure the baby is getting enough so they’re gaining weight appropriately. midwives monitor progress at home visits.

“i will preemptively tell people that it’s very common for it to take up to two weeks to be able to find your groove for breastfeeding,” she says.

the challenges to troubleshoot are a painful latch that can lead to nipple damage and soreness and then managing supply in the first few days or sometimes longer. it’s common for people to experience some form of breast engorgement, she notes of the condition where breasts become overly full, firm, swollen and sometimes painful. it happens as you transition from early lactation to full milk production because the increased blood and lymph flow causes fluid buildup in the breast tissue. engorgement can also happen later if breast milk removal is inconsistent.

“that requires management or at least you need to know what to expect and when it will go away. and some people need help managing their supply thereafter as well.” other less common concerns are plugged milk ducts or mastitis, which is a breast infection where midwives can help manage and prescribe antibiotics if needed for infection.

while vigorous massage to break up a clot was considered the course of treatment for plugged milk ducts, now the treatment is rest, anti-inflammatory medication like ibuprofen and gentle lymphatic drainage massage, marita advises, with an added caution to see your care provider if you’re starting to feel unwell.

demands of feeding every two to three hours

the most significant challenge, however, is frequent feeding. babies feed about every two to three hours, she notes, which tallies about eight to 12 feeds within a 24-hour period. there’s also “cluster feeding” where once a day they’re feeding almost continuously, typically in the evening and early morning hours. “knowing that that’s normal and also knowing that as baby gets older, they tend to have some longer stretches between feedings, ideally, at night for the parents to sleep up to four to six hours,” she says.

“how long that process goes on varies baby to baby, but it’s very, very normal for this to be the norm until they’re starting solids. so at least the first six months.”

martia also talks about the merits of breast milk for maintaining health and protecting against infection. she tells parents that the body adjusts the amount of hydration or water in your breast milk based on how hot it is outside and how much the baby needs that day. if the parent or the baby is exposed to some sort of infection, the baby introduces that pathogen to their body and the parent produces antibodies for it, providing those antibodies for their baby through breast milk.

“it’s helpful for people to know breast milk is food, but it’s also comfort. it’s also infection control and a health benefit. it’s something that can be a beautiful thing if you have the appropriate support and if it’s something you want to do.”

relying on community

when it comes to support, having a partner or family member by your side can be a lifesaver, especially during the first weeks of adjustment. what’s key is that partners understand what’s normal for nursing and the feeding schedule and help to provide the support that person needs with everything else.

“the best thing you can do if your partner is lactating is bring them food, bring them water, keep them hydrated and check in with them. do they need anything to make them feel comfortable? also helping to organize other supports that might be needed, like lactation consultants.”

if you can, outsource everything else in those first few weeks to people in your circle, like food and laundry in that crucial time where you’re establishing breastfeeding or other feeding.

mental health also needs attention, so marita advises clients to be mindful if they’re experiencing any “big emotions,” including anxiety, sadness, rage and to talk about them with those closest to feel supported. “those feelings can be very normal as you’re navigating this really challenging time,” she says.

“take it day by day but know that probably it’s going to feel quite different when you’re two to four weeks in than you are on day three when things are particularly challenging.”

national breastfeeding weekis celebrated in canada from october 1 to 7.