A baby’s birth is a life-changing event. Not only does a little human being give their first breath, but a woman becomes a mother.
The physical and emotional effects of birth on both mom and baby are more far-reaching than most people may think.
One of the areas most affected is breastfeeding.
According to the South African Demographic and Health Survey of 1998, approximately 88% of mothers initiated breastfeeding at birth.
However, only 10% of babies were breastfed exclusively in the first three months of life, with less than 8% reaching the 6-month mark.
These are rather old statistics, but they still sound fairly accurate to me, as a well-baby clinic sister and lactation consultant. This makes South Africa one of the countries with the lowest breastfeeding rates in the world.
Of course, there are many reasons for these low breastfeeding rates. Let’s take a look at how labour and birth influences breastfeeding
Before you proceed…
The purpose of this blog is to provide pregnant couples considering their birth options with information on birth and breastfeeding, not to cause anxiety and guilt feelings for those mothers in which all had not worked out the way they planned.
No matter how difficult your birth was, from the very first moment after birth you have the power to do things differently.
With perseverance from the mother, continuous skin-to-skin contact and good breastfeeding support, most babies hampered by a difficult birth experience will still be able to successfully breastfeed.
When in doubt, speak to a lactation consultant. Hope and help is always at hand.
READ MORE: How to boost your milk supply
I’ve included a few pointers on planning a breastfeeding-friendly birth as well as dealing with a difficult birth at the end of this blog.
Every mom wants what is best for their babies – but some things are simply out of our control (and perhaps this is the very first lesson that you need to learn on your parenting journey).
The role of natural birth in breastfeeding
A woman’s hormones during natural birth kick-starts breastfeeding and breastmilk production.
Oxytocin is the hormone responsible for contractions in labour. It remains high in the body in the early days after birth, and are also excreted when baby latches and sucks.
During breastfeeding oxytocin causes the milk ducts to contract and excrete breast milk. It also helps mom to bond with baby and to cope with the adaptation to a new baby.
Another important hormone is beta-endorphin which is a pain-relief hormone that helps a woman cope with labour pain. This hormone helps the newborn baby to adapt to the stressful environment outside the womb. Lower stress levels in babies will indirectly reduce the chances of breastfeeding and latching difficulties.
Cortisol is a stress and a steroid hormone that naturally rises in a baby’s body in the days before a woman goes into labour. This enables a baby’s body to better transition from the inside of the uterus to the stressful outside world.
Birth interventions and breastfeeding
Routine practices like brightly lit birthing rooms and hospital noises in the background inhibits a woman’s normal hormonal workings and may lead to other interventions that could have been prevented.
Simple changes like dimming lights or drawing curtains and playing soft music to drown out background noises can go a long way towards positively influencing birth (and subsequently breastfeeding).
Various interventions have the potential to disturb birth. Remember that it’s always about measuring up risk versus benefit. For some women and their babies these interventions are indeed needed, while for others it will do more harm than good.
- Induction of labour (IOL) – The risk of a labour complications like fetal distress and emergency caesarean section are higher in induced labour. More women will also experience the need for pain medication in labour. These can negatively influence breastfeeding.
- Pethidine injections for pain relief – In most South African hospitals the opioid Pethidine is routinely offered to labouring women for pain relief. It is transferred to the baby via the placenta, and can make baby sleepy and less likely to latch in the early days after birth. It can also suppress breathing in a baby after birth and lead to admission to NICU. It may cause drowsiness and nausea in labouring women.
- Epidural anaesthesia – Epidural anaesthesia is currently the most effective pharmacological method of pain relief in labouring women. However, epidurals disrupt birth processes in major ways, and typically go hand-in-hand with other interventions like instrument deliveries and caesarean sections. Overall, studies seem to link epidural anaesthesia to more feeding difficulties in the early days and to shorter duration of breastfeeding.
- Instrument deliveries – Instrument deliveries include suction and forceps births. It may cause swelling and superficial injury to baby’s head, which is painful and will definitely impact on breastfeeding in the early days.
- Caesarean section – The majority of mothers delivering their babies in private sector hospitals in South Africa will do so via Caesarean section. A baby is often delivered 2-3 weeks before he would have come on his own, and there is a higher incidence of admission to NICU for breathing difficulties. Something many don’t recognize is the difficulty that a new mother faces when having to deal with a newborn baby while also recovering from major abdominal surgery. Due to all of the above, successful breastfeeding is more difficult after a Caesarean section.
Giving yourself the best chance for a good birth experience
If you are pregnant and planning a natural birth you should focus on the positive things you can do to boost your chances:
- Recognize that there is not one birth-option that will suit everyone. You need to do what is best in your circumstances.
- Choose your healthcare provider wisely. I especially want to encourage you to at least examine the option of birthing with a midwife, which are linked to better outcomes for low-risk mothers and babies. If you choose to birth with a gynaecologist, make sure that you have a birth plan that you discuss in advance and that your doctor is supportive of your informed choices.
- Attending antenatal classes is a great first step, but you need to also choose an antenatal teacher knowledgeable about natural birth who will teach you proper pain relief and coping techniques for a natural birth.
- If you have the funds available, using a doula for your birth will make a tremendous difference to your birth experience.
- Locate a lactation consultant in your area that you can call after the birth should you experience any breastfeeding difficulties.
How do you cope with intervention?
- Remember you fall pregnant to have a baby, not to have a perfect birth.
- It’s important to acknowledge your emotions, as negative feelings over your birth will also influence how you feel about yourself as a mother and may lead to postnatal depression.
- Do not obsess over things you cannot change. With a bit of patience, most problems potentially caused by birth can be overcome.
- Skin-to-skin contact and baby massage can help baby cope with any birth trauma.
- Take baby to a chiropractor, as Caesarean sections and instrument births may lead to malalignment in baby’s spine which can cause breastfeeding difficulty, cramps, colic and reflux in babies.
- If you had a suction delivery, position baby in a way that you prevent touching any bruising or swelling on baby’s head, as this can be painful.
- In the same way, you will need to find a position in which you can feed comfortably after a caesarean section (football hold is popular), or after a normal birth where mom has a tear or a cut (side-lying works wonderfully).
- Remember that birth is only one day – every day is the first day of the rest of your life!