The baby let out a wild cry the moment it came out. We felt triumphant. After a four week period of intensive supervision, the mother had finally delivered a healthy baby. I was a resident doctor in obstetrics and had stayed up for several long nights, struggling to help this woman to complete her nine months – complications constantly threatening to sabotage our plans. But now there was relief and joy as it had all turned out ok.
Or so I thought.
The next day, I found the new mother anxious. Desperately, she said: “I am unable to breastfeed. I don’t know what to do.” I tried giving her some tips but immediately realised I was as unable to get this baby to breastfeed as she was. Giving out a few customary instructions I moved ahead, knowing I had hardly made any difference to her anxiety.
The following day, the baby was in the Intensive Care Unit, having convulsed due to low sugars. I knew that meant potential for future intellectual disability. I glanced through the glass windows of the ICU and saw the mother standing besides the incubator. I had a sick feeling which I could neither deny nor escape; I had failed her. We had all failed her. Our moment of triumph was now no more. We had poured in all our collective efforts pre-delivery to bring forth a ‘healthy’ baby, but had ignored her post-delivery struggle with breastfeeding. We all assumed that it just happens naturally; every mother just knows how to do it. But this is far from true. They all need personal support and guidance.
I was suddenly acutely aware of my deficient skill set. As resident doctors, there had been more important things to update ourselves on; the newest infertility treatments and best ways to deliver high risk pregnancies. Breastfeeding was not something we were told to consider actively in our rounds or spend hours training ourselves in. Our singular focus as obstetricians had become to help deliver a ‘healthy live baby’ and as neonatologists, to ace resuscitation protocols when babies weren’t breathing at birth and then get busy with the incubators. With doctors’ alternative priorities and nurses’ preoccupation with injections and clerical work, whose job was it to look at breastfeeding?
The void in lactation support was glaring. I was restless. How can we make breastfeeding a breeze for mothers; a joyful journey of bonding and nourishment rather than a nightmare? That’s when our lactation consultant asked me to try ‘Breastcrawl’, a term I had never heard before.
Apparently, just like newborns of all animals, our babies have an innate capability to seek out the breast and feed; if left undisturbed and ‘skin-to-skin’ with the mother for the first crucial hour after birth. This is called ‘early initiation’ through Breastcrawl. I felt stunned by the potential behind this beautiful miracle of nature. It seemed to have all the answers for a successful start and continuation of breastfeeding! I attempted it in our labour room and sure enough, the baby crawled up from the mother’s abdomen to the breast, latched on its own and smoothly drank its first precious drops. Its reflexes were the only coach it needed. What a perfect start it was!
Breastcrawl has deep implications on health of newborns. As I started following up these ‘Breastcrawled’ babies in the wards, I saw that even the first time mothers breastfed with the confidence of a woman who had just had her third child! Science supports the impact of this technique way beyond just nutrition – sensory-neural development, immune priming, bonding, temperature control and more.
Every mother and newborn deserve this experience. But in our hurry to complete paper work and protocols, we had been thoughtlessly separating the mother and baby in those critical first moments and preventing this beautiful miracle from manifesting itself. Our support had been inconsistent and ill-timed. We were either getting in the way of mothers when we needed to step aside or we were simply too far away for help when mothers were desperately seeking us.
The experience with breastfeeding in my residency taught me how ‘lactationally illiterate’ I was. I learnt that supporting mothers in breastfeeding is as critical as doing a perfect caesarean surgery. Ensuring a ‘live birth’ was indeed just the first step.
As WABA keeps reminding us so rightly, babies are born, what do they do next? They breastfeed!