Yesterday was a normal day filled with consultations for new moms, dads, and babies. I am a lactation consultant in private practice, near Research Triangle Park which attracts the “Techies” of the world. Many come from India and surrounding countries. Families relocate, babies are born, and then end up in my office seeking resolution to their breastfeeding challenges.
I have noticed some behaviors that seem typical for most of the Indian families I see and one of the most lovely things is that usually one or more grandmothers has come to stay with the family for extended periods of time. Grandmother is here for six months or a year, doing all the cooking, cleaning, and caretaking of this new and vulnerable family. Often there is no English spoken by grandmother but she and I manage to communicate quite well through smiles, gestures, and hugs.
One of the questions I often ask new parents is “Were you breastfed?” The answer in this population is always, “Yes!” So, I have come to wonder day in and day out, then how in the world have we come to this place where you are feeding your baby formula by bottle and completely unsure and untrusting of breastfeeding. Oftentimes, baby has not been to breast in some time, milk supply is poor, and things have become very complicated.
The couple I worked with yesterday had a story that went something like this. Pregnancy was completely normal. Delivery went fairly well considering the usual interventions offered to women in hospitals in this area, but that is a whole other conversation. Baby girl was born and shortly after birth parents are told “blood sugar is low so we need to supplement.” WHAT? This is a normal, typical response to birth which when newborn is placed skin to skin, allowed free access to breast and given some time is typically self-limiting and resolves. And so it begins.
For the next 24-48 hours or so (assuming this was a vaginal birth –again – a whole other story), one “expert” or another comes to see this baby and family and the undermining of generations of innate knowledge, tradition and confidence dissolves. By the time I meet these new parents they are deeply entrenched in bad advice, poor habits, multiple interventions in what was meant to be a normal process, and suffering from stress and insecurity. They come wanting numbers, statistics, and precise direction as to what to do next. This is “breastfeeding” not brain surgery and it is thus, mostly an art, not a science.
So, this well educated couple being wooed by both the US and India for their highly skilled computer programing expertise, arrived in a sea of anxiety and insecurity. Their baby had not been to breast in her five weeks of life since the first day in hospital when parents were told, “she’s not eating and needs formula from a bottle.” This mom explained to me that her mother said she had never heard of a lactation consultant in India and wondered what there would be to do in such a job. She also questioned the fact that she and all of her friends and family had ALWAYS breastfed and didn’t understand why there were issues with this in America. And so, I asked this mom these questions. “Tell me how you ended up following all the conflicting advice you have been given over these last five weeks as opposed to following your mother’s collective wisdom that she has learned from generations of mothers before you.” The response knocked my socks off! “Well” she said, “If we are having our baby in the U.S. and in a hospital, then there must be ‘experts’ there who will tell us exactly what to do and they probably know better than all of our ancestors. So, even when what we are told is directly opposite from what we have done for generations, we figure we should follow the directions we are given. And, we also feel a bit afraid, not to, because we are made to feel that then our baby may not thrive.”
As I sat opposite this mom with tears in my eyes, I realized this was a pivotal moment in my understanding how things run amuck in newborn journeys and why I meet these families in lactation crisis time and time again where mom is pumping and buying one bottle type after another and trying to find the one formula that will stop making baby vomit, etc. There is a very frantic nature to these meetings with baby screaming, parents chanting loudly some phrase that they assume will magically quiet baby, but it never does and the crescendo escalates. There is holding and rocking, and passing baby around and it becomes overwhelming in my tiny office.
My job becomes one of convincing baby that the breast can actually be a good place and imagine – one where feeding can occur! Most babies who have spent little or no time at breast are not buying it. Nope – I’m hungry, ready to eat, and not fooling around with this other system. It is most challenging and frustrating for all and though it can take a long time of rebuilding a milk supply, correcting any suck or latch issues at hand, peppered with a great deal of patience, we can get back on track, but not always. The undoing of the dismantled parental self-confidence is often the greatest challenge.
And so yesterday, I encouraged this couple to look back to their roots, to speak with grandma some more and employ her collective wisdom. I stepped back, trying to relinquish my role as “expert” realizing the last thing they needed was more details or facts but rather a restoration of their now lost confidence and wisdom.