“Ayesha doesn't like my breast milk!" the young mother declares. "I guess it's time for formula."
Ayesha was born two weeks early, after a long labor and an epidural. The baby's initial suck was a bit unorganized. In addition, her bilirubin was elevated, and she had jaundice for a couple of days. Though she ended up with a few bottles of formula in the hospital, the baby was breastfeeding at discharge.
But today the mother's words are a surprise to the nurse at the community clinic. Exclusively breast-fed, four-week-old Ayesha had regained her birth weight in just ten days and is now growing at an amazing, one ounce-per-day. The nurse sees the baby's cheeks filling out, and she is "filling" her diapers with gusto. Why is this mother thinking that her breastfeeding is going poorly?
"She just doesn't seem satisfied," Ayesha's mother explains. After a deep sigh, this young mother adds, “She seems to be crying much more now than she did last week.”
The young mother lifts Ayesha out of her car seat. Ayesha has a startle and moves quickly from the peaceful, Ready Zone, to crying intently. This mother pats her baby's head, jiggles her on her shoulder, stands up and walks around the room, and talks to her baby in an energetic (if somewhat anxious) voice.
Research on breastfeeding demonstrate that this mother's feelings are common: Mothers often notice non-feeding behaviors and worry that these are signs of inadequate milk. In addition, mothers who cannot manage their infants' crying are less likely to continue breastfeeding and more likely to develop postpartum depression.
The nurse remembers that babies born early increase their crying at just this age. She also considers that this baby has risk factors for Zone regulation issues, which could make her a baby who fusses more than many. Perhaps a stepwise approach to calming this baby will help Mother both settle the baby and appreciate her daughter's capabilities.
"Let's see how your baby responds to your voice," the nurse remarks. "Many babies like that sing-song voice you were just using."
With some encouragement the mother leans over the baby and repeats several times, "Hey little one! I see you are trying to calm down." The nurse then encourages the mother to bring the baby's arms to her chest while continuing that sing-song voice. Next the nurse shows mother how to sway the baby. Almost like magic, Ayesha takes a big breath and stops crying.
The nurse describes the behavior she now witnesses. “Though Ayesha needs your help right now, she looks so content in your arms. When you talk to your baby her forehead relaxes, her eyes widen, and her eyebrows go up.” A moment later she goes on, “When you speak, Ayesha lifts her face toward yours and slows down her breathing.”
At the end of her visit with this family, the nurse encourages the young mother to call her baby's name. When she hears her mother’s voice, the baby initially gets still; then her eyes shift up toward her mother. The mother is delighted to see her daughter's eyes “lock” in an endearing gaze. With a big grin Ayesha's mom lifts her from the nurse's hands and snuggles her face into the baby's soft head. One of the mother's hands go to her breast to suppress the unexpected let-down of milk.
Three months later, Ayesha's mom is a breastfeeding star and a support for other new moms. One afternoon she comes to the nurse's breastfeeding class to discuss the challenges and joys of breastfeeding. Cuddling with her baby, she remarks, "Don't just count those pees and poops. Learn about the amazing abilities of your newborn, and you'll know for sure that your breastmilk is perfect!"
© HUG Your Baby 2020