Breastfeeding Initiations-

In the new-born’s habitat, the mothers breast delivers all the

basic biological needs to the fetus:
Oxygenation
Warmth
Nutrition
Protection
Mutual Regulation-
Infant:
•Eye to eye contact when in mothers’ arms, STSC or
breastfeeding leads to brain cells (neurons) being activated
and fired up in the areas concerned with vision & facial
recognition. As this is repeated, more connections are wired,
resulting in the baby beginning to recognise the mothers
face. •Mothers body is able to regulate the baby’s
temperature & respirations.
•STSC activates the baby’s parasympathetic nervous system-
the “rest & digest” body program that switches off stress,
enhances digestion, healing, growth & imprints calm &
connection through the hormone of oxytocin.
•STSC reduces Newborn stress and stress hormones,
optimizing Newborn transitional physiology, including
energy consumption, glucose levels, respiration, crying and
breastfeeding behaviours.
•The new-borns actions elicit care taking responses from the
mother.
•Immediate skin‐to‐skin contact provides the initial
colonisation of the baby's microbiome outside of the
mother, a swarming of the mother's skin bacteria
Mother:
•Contact with her baby enhances her mothering hormones,
oxytocin & prolactin, helping her to regulate her maternal
instincts & behaviours.
•Uninterrupted SSC and breastfeeding initiation may
promote further rises in maternal oxytocin, and prolactin
promoting breastfeeding, a strong attachment and possibly
preventing postpartum haemorrhage.
•STSC, breastfeeding, carrying increases maternal hormones
which activates the brains maternal circuit, which stimulates
maternal behaviours in all mammals.
•The maternal circuit includes a powerful reward system,
which motivates mothers to care for their offspring and
rewards them for it.
•Oxytocin -reduces stress, make mother calm.
•High levels of Prolactin- help women to mother well by
making us more “tolerant of monotony”
•Beta-endorphins released in close body contact. Benefits of skin to skin contact-
Innate feeding sequence-  Calms mother and baby
Being able to smell my Mum & hear her voice.  Regulates baby’s heartrate and breathing
Being able to rest from the journey in the security of Mum  Stimulating the baby to exhibit pre-feeding
Lick and suck my hands behaviour such as salivating, rooting, searching
Search the breast with hands and mouth Root. and crawling to the breast
Turning my head from side to side.  Helps mother’s uterus to contract by stimulating
Massage my Mums nipples with wet hands the release of oxytocin via early breastfeeding,
Drop my tongue, mouth open wide and I’m latched drinking thus controlling post-delivery blood loss
that colostrum  Encourages human babies normal post birth
habitat- the mother
 Parental touch helps to wire the baby’s brain
 Encouraging the start of a close and loving
relationship between mother and baby
Breastfeeding Initiations-
STSC helps wire the neonates brain-
Research in neuroscience has shown that touch is necessary for
human development and that a lack of touch damages not only
individuals, but our whole society. Human touch and love is
essential to health. A lack of stimulus and touch very early on
causes the stress hormone, cortisol, to be released which
creates a toxic brain environment and can damage certain brain
structures.
Environment-
The mere presence of the mother not only ensures the infants
well-being, but also creates a kind of invisible hothouse in
which the infant’s development can unfold.
Importance of smell-
Babies are eager to learn the smells: they can identify their
mother by odours such as her amniotic fluid which lasts for at
least forty-eight hours, sebum, colostrum and maybe even her
level of oxytocin. Returning to their mother and the host of her
odours will reduce his stress protest by 70%.
Summary-
 Educating Mums on the Human babies’ normal post
birth habitat- HER
 Educate Mums & Dads on the importance of STSC
 Encourage Skin to Skin contact with those Mums &
Babies you deliver.
 Acknowledge the importance of smell to a Newborn-
encourage Mums not to wear scents following delivery
up to 48 hours/ not to wash from waist up for 24 hours
 Midwife to think about not wearing strong scents to
work.
 Educate Mums on why new-borns do not like to be
separated/ put into cots etc / why they calm when
held frontally
Biological Nurturing-
•Biological Nurturing (BN) brings the focus of “nature to the
fore”
•For over 300 years mothers have been taught how to
breastfeed. Women have acquired the skill.
•Mothers develop the capacity to breastfeed in many different
ways that include both instinctual and learned behaviour.
•BN acknowledges maternal instinct and knowledge.
•It attempts to highlight maternal competence.
3 most common reasons mothers give up in the first week: 35%
Latch refusal (Baby would not suck or rejected breast) 25% Milk
Insufficiency 24% Sore nipples or breasts
What is it?
•Biological nurturing (BN), is a newly developed approach to
breastfeeding, promotes early and extended baby cuddling in
relaxed maternal postures where the baby’s body is in close,
facing and touching maternal body contours. •Building upon
and exaggerating the skin to skin neonatal positions currently
advised, BN includes such feeding behaviours as face-to-breast
contact whilst the neonate is asleep, licking, nuzzling, rooting
and latching onto the breast as well as active milk ingestion.
•The degree of maternal recline optimises baby gazing eye to
eye contact, releasing spontaneous breastfeeding behaviours.
•The baby’s movements release some 20 primitive neonatal
reflexes, which facilitate the latch.
•In BN mother and baby actively participate.
•BN is a proactive, mother-centred approach that reduces
the time of the baby to latch.
•After birth mothers should be encouraged to practise BN
in as much STSC as they desire.
•If the baby is at the “Right address” the mother does not
need to be undressed.
Biological Nurturing components-
•The positional components of BN brings rewards to the
mother by reducing muscle tension & fatigue many
experiences in an upright breastfeeding position.
•In BN women sit semi-reclined, with glazed eyes, a subtle
smile, facial blushing, low body tone as she gazes into the
baby’s eyes.
•Gravity plays an important role in BN, as it helps babies
latch and relieves any need for the mother to touch or
manipulate the baby’s head or neck. Gravity reduces breast
fighting & sore nipples.
•BN takes the pressure off women’s perineum’s making
the position comfortable and sustainable.
•Babies are able to attach to the breast in several
behavioural states including sleep states.
Maternal Posture-
In BN what’s important is that the mother’s back is
supported, touching the back of a chair, sofa or the bed.
•Build upon postures
•Sacral reliance but not flat lying
•Where every maternal body part is supported
•Open the maternal body
Full BN Position-
•Full BN position =The baby’s body is lying prone on top of
the mother
•facing
•touching
•closely applied to a maternal body contour or part of the
environment
•Introducing a new positional variable: Postnatal lie.
Longitudinal/oblique or transverse.
•Allow your arms to rest either side of the baby, making a
nest.
Postnatal Reflexes-
•Innate Behaviours
•Anti-Gravity (finding/latching)
•Head righting
•Head lifting
•Head bobbing
•Crawling
•These reflexes are active for up to 3 months postnatally.
What does all this mean for practice-
•We should all be allowing mothers to have unlimited,
unrestricted skin to skin contact with their babies, as soon
afterbirth as possible
•This is especially important when labour may inhibit or
reduce the mother’s own production of oxytocin i.e..... The
use of epidural, The use of oxytocin, Instrumental or
operative delivery
•BN should be encouraged for all breastfeeding mothers as
it encourages comfort & increases maternal confidence.
•An oxytocin environment is required to encourage
instinctual maternal behaviours.
•Hence, the role of all midwives in the first 72 hours should
be to protect the mother’s privacy, be mindful of negative
language, provide praise and reassurance.
Immediate post-delivery care- Restoration-
Why does it matter? Restoration in the right habitat will see somatostatin
•Birth interventions that disrupt the natural interaction eliminated from the system in 20 -30 minutes.
between the mother and the infant in the immediate Post-delivery practices that negatively impact on the first
postpartum period can impact long-term breastfeeding success. feed-
The medicalisation of birth and postpartum processes has •Other factors-
created additional barriers to successful breastfeeding. A •Mothers smell important
mother’s breastfeeding experience can be profoundly affected •Maternal medication, pethidine & analgesia will affect
by what happens during the first hours after birth. baby’s ability to feed & can depress the efficacy of early
Implementing skin to skin contact- suckling
•The benefits and process of STSC should be discussed with •Forcing the infant on the breast may disturb the rooting
parents prior to delivery, to stress importance of STSC and reflex, altering the tongue position as the baby raises her
successful first feed. tongue to protect airway.
•STSC should be commenced within 30mins of delivery and •Possibility of negative association of the breast with head
continue for at least 1 hour or until the baby has latched and manipulation and manhandling of the baby manually
feed from the breast. putting the baby onto the breast causing early breast
•Baby should be delivered into the mothers’ bare abdomen, refusal.
ensuring the mother is first to embrace her child.
The head and body can be dried without interrupting the
process.
•The baby’s head should be just below the breast or nipple line
but never above the breasts.
•The baby should be covered with blankets to enhance warmth
for mum and baby.
•This process is facilitated by an unhurried, calm and relaxed
atmosphere.
Importance of first feed-
•Most babies born of unmediated births will self-attach and
suckle correctly in fewer than 50 mins.
•Healthy infants should be given the opportunity to show
hunger and optimal reflexes and attach to the areola by
themselves.
•An infant’s suckling reflex is the most intense 45 minutes
through the second hour after birth. Delaying this first
opportunity for suckling may make it more difficult for the baby
to learn this skill at a later opportunity.
•An early milk feed will help elimination of meconium help
maintain normal blood glucose levels provide time for sensitive
bonding calm the baby and boost a mother’s confidence.
Post-delivery practices that negatively impact on the first feed-
•Delay, minimise, or eliminate postpartum procedures that
interfere with the first contact; stress on the neonate from
procedures can result in sensory overload and cause the baby
to temporarily shut down in order to reorganise his or her
nervous system.
•All babies need to be placed on a warm towel in a prone
position on the scales for weighing. This ensures that the Moro
reflex is not elicited, which occurs when babies are weighed in
the supine position. During the Moro reflex adrenalin is
released which affects normal neonatal physiology.
•Babies separated from their mothers will cry in pulses until
reunion with their Mothers. This will cause the release of stress
hormones in both baby and the mother hampering the baby’s
ability to latch and Mum’s ability to relax and produce those
essential hormones of oxytocin and prolactin essential for
feeding.
•One hormone in particular SOMATOSTATIN is produced. This
hormone acts directly on the gut and has a powerful Inhibitory
action on the 20 or more hormones that regulate Every aspect
of gut function. It also inhibits the production of growth
hormone. Its own direct effects are to inhibit gastrointestinal
Secretion, inhibit gut motility, reduce blood flow and
absorption from the gut