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Saturday, 9 March 2013

Put away the clock: The beauty of nighttime breastfeeding

 
"Is she sleeping through the night?"

This is probably one of the most common phrases a new parent will hear.

I just typed 'baby sleep' into Google, and it returned 362 million results—with the top hits headed 'getting a baby to sleep', 'help your baby to sleep', 'teach your baby to sleep'.

Where does this obsession, this market, this world-wide 'problem' come from? Homo sapiens, human beings as a mammal, have been breeding for thousands of years. We need little encouragement to eat or drink or to reproduce. Have we really evolved into such an intelligent, complex species yet managed to somehow make a complete mess of something as essential to survival as sleep?

Baby Sleep—a highly lucrative market
News.com.au recently published an article that perplexed me somewhat. Entitled Broken sleep 'normal' for parents with breastfed babies, the article was an attempt to reassure parents that it is perfectly, biologically normal for breastfed infants to wake multiple times during the night to breastfeed. However, after citing the study that claims to reassure parents of the normalcy of night-waking in breastfed infants, the article summarises with a quote explaining the success of introducing solids to seemingly solve night-waking, and a quote from Tizzie Hall claiming baby routines have some benefit in persuading a baby to conform to adult sleep stretches: 
'"In my experience, breastfed babies who follow a routine will sleep through the night sooner than a baby fed with a bottle," Ms Hall said.'
In other words, it might be 'normal' (news.com.au's use of inverted commas would imply otherwise), but you can (and probably should) try and fix it.

Anyone who has cared for a newborn could probably tell you why we are so obsessed with 'baby sleep'. The sun goes down, and the digits on the clock glow like accusations into the night. Counting the minutes, adding up the hours, pacing the halls with an infant who cries or stares happily at you, and you wonder, as your eye-lids droop like paperweights, if you'll ever sleep more than forty-minutes in a row again.

Babies don't sleep like adults. Babies snatch little snippets of sleep around the clock, waking irregularly and requiring parental assistance to be soothed to sleep. A newborn in particular still runs on 'womb time': where in utero they were held and fed constantly, 24/7. So newborns often take a bit of adjustment to get used to the outside world, the day/night cycle, and the strange and unsettling new sensations in their digestive system that is hunger, fullness, wind, bowel movements.

Additionally, more often than not, our adult lifestyles simply aren't conducive to accommodating the tiredness that results from prolonged interrupted sleep. We have work schedules to adhere to, we have other children to take to school and to care for. We have large houses to clean, meals to prepare, mountains of clothing to wash. And more often than not, as mothers we're alone in those houses and our partners are held to their work commitments by rules and regulations that leave little wiggle-room for parental flexibility.

In an article that explores the discrepancy between biologically normal infant sleep and western cultural infant-care practice, Dr James McKenna et al write:
'... evolutionary pediatrics makes it clear that notions about what human infants need and why, especially as regards nighttime sleep and feeding patterns, seems to reflect far more about what societies want parents to be and infants to become (self- sufficient and independent) rather than what infants actually are—exceedingly dependent, and unfinished ‘‘extero-gestates’’ to use Montagu’s (1986) description. Indeed, especially in early human infancy—and from an evolutionary point of view—reference to the mother’s body is critical to understanding not only what infants need but what they can and cannot do and why. After all, as Hrdy (1999, p. 69) aptly puts it: ‘‘For species such as primates the mother IS the environment . . .’’ meaning that practically nothing about a human infant makes sense except in light of the mother’s body.'  (McKenna et al, 2007)  
The way we expect our babies to sleep (separately from parents, without breastmilk, independent of parental assistance, and for exceedingly long stretches) is at complete odds with how our biology instructs babies to sleep: close to mother's body, rousing frequently for the survival and comfort of mother's breasts and nutrients of breastmilk.

As a society we do, however, show a tolerance to some level of interrupted sleep in the early weeks. But for some reason, our culture tends to frown on this pattern continuing any longer than a handful of months. By the time our babies are several months old, most people expect the baby to sleep long stretches uninterrupted, and to need little or no parental assistance to settle upon waking. Consider again the news.com.au article linked above:
"... breastfeeding mum Melanie Lawrence managed to get daughter Scarlett, now six months, to sleep through the night only at five months when she introduced some solids."
Despite the fact that the World Health Organization (WHO) continue to urge parents to breastfeed exclusively for a minimum of six months, many parents feel pressured to feed solids earlier in order to achieve longer stretches of sleep. For other parents, the well-meaning advice might be to give a bottle of formula to a breastfed baby, or to leave baby to cry, or to pat baby in the cot, or any other manner of 'fix' to 'get' a baby sleeping longer stretches.
'The dominant expectation for these initial months is parental sleep deprivation—their infant’s sleep patterns do not match their own, and parents, desperate for a ‘‘good night’s sleep,’’ seek the magic solution for achieving a somnolent baby. Baby’s grandmother advises a large bottle of formula at bed time so that baby will not wake to be fed in the night. Others suggest adulterating the formula with baby ce- real for greater infant satiation or medicating baby with proprietary infant pain killers or colic remedies ... to ‘‘knock the baby out.’’ Friends sing the praises of ‘‘Ferberizing the baby’’ or similar infant sleep training programs employing an oxymoron known as ‘‘controlled crying.’’ Parents, who feel all else has failed, resort to the painful approach of ‘‘crying it out’’—and while their infant screams alone in an adjacent room, they lie awake racked with guilt, forcing themselves to resist respond- ing, reassuring each other ‘‘it is for his own good’’—until the infant eventually collapses from exhaustion into sleep.'  (McKenna et al, 2007)  
It stands to reason, then, that anyone with a wakeful older baby or toddler feels like a complete failure. I've been there!

I recall hearing a saying amongst natural horsemanship circles: 'people don't have problem horses—horses have people problems.' I think the same is true with human infants. It's not the baby that has a 'sleep problem'—it's that the adult/s in the house aren't equipped to deal with the biologically normal interrupted sleep of an infant.

How are babies so different from what we culturally expect—and try desperately to obtain via a myriad of sleep 'programs'? And what affect does this have on our babies, and our mothers?
'.. arousals lead to the baby breathing more stably over time, and to more variable heart rates and breathing. Variability in breathing patterns of infants is good and a sign of health, ordinarily, and such variability is  often associated with more substantial inhalations of oxygen, leading to shorter apneas in deep stage of sleep from which awakenings can be difficult (see Richards et al  1998). Moreover, if practice makes perfect than the more arousals induced by various forms of co-sleeping the better the arousal skills that potentially can act protectively in response to a cardiac or pulmonary crisis.  
Babies are not designed to sleep through the night in the first six months, at least, of life. They are designed to wake often to breastfeed. Breastmilk does not have dense calories i.e. caloric staying power that keeps a baby sleeping, in the way that cows milk does, for example as it is obviously designed for optimal cow brain growth and development.' (Dr James McKenna)
Human babies are designed to sleep alongside their mother, to breastfeed frequently, and to wake frequently to ensure survival. Breastfeeding reduces the risk of SIDS. But our (patriarchal) cultural preference is for babies to sleep independently and to re-settle alone. We have a high breastfeeding initiation rate that drops significantly within weeks—thusly stripping parents of Mother Nature's intended sleep-inducing mechanism: the close, quick and easy comfort of a mothers breast throughout the night.

Human infants are born exceptionally immature. Human infants are designed to receive breastmilk; breastmilk is designed to be quickly and completely digested, and to be consumed frequently and in small doses to aid such digestion in an immature gastrointestinal system and to accommodate and nourish the rapid body and brain growth human young undergo in the early years.

Breastfeeding releases a hormone called cholecystokinin, (CCK) in both mother and baby. CCK causes both mother and baby to feel sated at the end of a feed. Breastmilk also contains CCK.  (1) Moreover, prolactin, the hormone responsible for lactogenisis II (milk production) and sometimes referred to as the 'mothering hormone' naturally occurs in the mother's body in higher levels at night. (2)

Quite simply, babies and their mothers are designed to stay close to each other, and to rouse frequently to breastfeed throughout the night.

There is no truth to the myth that a co-sleeping baby will never sleep independently. Otherwise, mosts humans would still be sleeping alongside their parents. It's what we've done as a species for pretty much the majority of our existence, and what most of the world continues to practice. It's just we in the West that do things (oddly) a little differently.

My now five-year-old slept alongside me and breastfed frequently through the night since birth. She began to go longer stretches at night without breastfeeding some time in her third year, and she was gently night-weaned when she was about three. She remained sleeping alongside me in bed, sometimes in her own bed that was pushed up to mine, sometimes rolling right over to sleep under my arm. Just recently, she quite suddenly declared that she would like her own room. She goes to sleep with a cuddle from myself or my husband, in her own room, and stays there until she wakes in the wee hours of the morning and creeps in alongside me, usually without waking me at all.

Feeling exhausted? From one breastfeeding mother to another, from one mother of wakeful babies to another, I suggest you put away the clock. Time serves no purpose in your bedroom but to remind you of something that our culture, despite all it's good intentions, just doesn't have biologically right.

Learn about safe co-sleeping and breastfeeding laying down. Minimise your priorities in the day (do you really need to mop that floor today, or can it wait until tomorrow?) Ask for practical help with cooking and housework, surround yourself with nurturance and good support. Forgive yourself for not being perfect, remind yourself that you are wise and your baby is normal—and will outgrow this. Eventually. And in years to come you will look back and miss those cuddles.

Peace and love to you. xo


References:
(1) Bodribb, Wendy. Breastfeeding Management (3rd edition). 2006. Pg 101.
(2) Bodribb, Wendy. Breastfeeding Management (3rd edition). 2006. Pg 7.

14 comments:

  1. thanks for sharing.

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  2. A friend just referred me to your blog and I'm very glad she did. I'll be suggesting that my new mummy friends read this as even for those with "sleepers" it at some point always becomes an issue that perhaps with a refocus we wouldn't think of as an issue. "Forgive yourself for not being perfect remind yourself that you are wise" - trust yourself. Love this! Thanks

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  3. As a now non practising midwife older mother meditator aspiring poet writer I feel grateful to the Emerging Writers Festival where I wrote down your blog title. Well done. Very well done. Thank you I will recommend you to others.

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    1. Hi avigail, thanks so much for taking the time to comment. I'm so disappointed I missed EWF due to illness! :( Otherwise I would have been there. I'd love to hear what you thought of the festival, and where you found the blog recommendation :) Cheers, Kim xo

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  4. Bravo! I have been telling people for ages "I have never seen a teenager still sleeping with their parents" when ever they co-sleeping. My DD slept in a bassinet for the first 8 weeks, right beside me in my bed. Now she has her own cot, simply because Dad and I are night owls (always have been)and leaving her alone in our bed, we are likely to either a: not fit into it after she sprawls, or b: she rolls out of it. She is only a year old. But at her wake up at 4am, she comes into our bed and feeds when ever she needs it so we can all sleep till at least 7am, when she wakes up with dad, who lets me sleep till nearly 8am. I would not change our routine for the world, and I enjoy 90% of the cuddles I get after 4am, (the other 10% is when she bites in her sleep (ouch), or pushes at least one of us out of bed (sleeping sideways between us). People still tell me to this day "she doesn't need to be fed at night time" my reply is "if she didn't need to be fed, then she would not wake up for a feed, or she would not take a full feed". On days where we have had a tough night, we co-sleep for the afternoon sleep, on the couch together :)

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  5. Thank you! My Lactation consultant posted your blog on FB and I am now recommending it for my friends and family to read, especially my mates that are soon to be mums. I wish I had found this sooner, though Im not a big co-sleeper person (Im too afraid I would squish him or he'd roll out of the bed) but I really like what you have said about it. Thank you for sharing.

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  6. Very interesting article and I wish this would have been possible for me to do. So I am wondering how a mother can manage a houshold and a full time job at the same time while being totally sleep deprived? Are you writing about super humans? I have been exhausted after 7 months of feeding throughout the night and sharing my bed with my baby. I had to wean him off during the night and get him into his own bed, else I would have gone crazy. I did not even enjoy playing with him any more, let alone having any conversations with my husband. All I wanted was sleep. Maybe this works well for stay at hom mom's in their 20ies? Nevertheless its really good to see supporters of co-sleeping and late weaning off.

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    1. Hi Anonymous, sleep deprivation sure is difficult. I'm sorry you've been so exhausted and under-supported. Mothers need support. The right support. Help around the house, etc etc. I hope your husband took over the housework/cooking/washing etc so you were able to get some rest. :) Unfortunately we often live very isolated from any real support, and sometimes women are still expected to 'keep house' and as a result, the baby's need for his/her mother is what has to be severed in order for the mother to cope. This isn't fair on the mother nor the baby. Patience, understanding and nurturance through this phase—regardless of whether the mother works at home or outside (is it REALLY any less exhausting for a SAHM??)—is what helps get through this time that is very short in terms of a child's lifetime. xo

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  7. I love this article so much. Stopping watching the clock, literally saved my sanity, while continuing to respond to my baby's needs. I returned to work when my daughter was 5.5 months old and continue to breastfeed (she was exclusively breastfed until about 9 months) and cosleep now that she is nearly three. My job is busy and demanding however, I really feel that cosleeping and not caring what the clock says has really saved me. I'm not saying there aren't ups and downs... of course there are. I'm not superhuman, I'm just a mum, doing lots and doing my best to meet the needs of my child as well as my own. It's important to do what works for you, and this approach certainly has for me. Throwing away our culture's obsession with controlling a baby's needs also helped me. Wakes 10 times a night? So what?! Thanks Little Leaf for keeping it real and being a voice of support and empathy. Love you xx

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  8. Great article. I love to read facts that agree with what I just knew! Another big benefit of night time breastfeeding is that ovulation is postponed…nature’s way of spacing children.

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  9. Hi unfortunately not all of us can breastfeed- in the case of adoption and fostering bottle feeding is the most accessible option

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  10. Why didn't I find this article earlier??!! Thank you for your words. I am breastfeeding my second child, a 7 month old boy. Whilst I adore breastfeeding and love co-sleeping with him, I find that I am constantly second guessing my instincts because of the reaction I get from people when I tell them that he wakes up to 5 times overnight for a feed. Our 3 year old daughter also sleeps with her brother and I, and whilst some days I feel as though I literally have no space, there is no feeling more amazing in the world than waking up and feeling the warmth of your precious angels beside you. When it all starts to get me down, or the judgements of other people make me question our methods, I remind myself that this is our reality and not theirs...and most importantly that it's not forever and when I have weaned and they have left my bed I'm going to miss those snuggles.

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