How Birth Can Impact Breastfeeding: What Childbirth Educators Want You to Know about Common Medical Interventions by Brave Birth Collective
Introduction
We’re back with a special blog post this week from Brave Birth Collective. Here at The Breastfeeding Center we strive to partner with progressive and integrative organizations who prioritize advocacy and accessibility to care and knowledge for their clients and community. With that said, we are so excited to talk with the up and coming Brave Birth Collective team. With a focus on pregnancy, they work to bring childbirth education to the forefront - as we know knowledge is power, and being informed during birth can lead to better outcomes. Today, Brave Birth Collective gives us an inside scoop on the interventions and medications that could impact your birth.
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As you prepare to welcome a new baby, you may be full of questions about what life will be like with a newborn – and one of the most important considerations, of course, is how your baby will be fed. If you’re hoping to breastfeed or chestfeed, you may be thinking about what kind of pump to use, taking a breastfeeding class, and reading about what to expect when nursing. What many parents don’t realize is that what happens during your birth itself can actually impact the beginning stages of breast/chestfeeding and that being prepared for birth is part of being prepared for breastfeeding.
In the childbirth preparation courses we teach at Brave Birth Collective, our focus is on making our clients feel empowered to advocate for their rights and preferences in labor and birth, but also making sure they are informed about the side effects and benefits of common medical interventions they may encounter in a hospital setting so that they can ask the right questions and request support when it’s needed. All too often, we find that new parents don’t fully realize how their birth experience can impact their postpartum recovery and their breast/chestfeeding journey with their baby.
The following common interventions and potential side effects can be experienced differently by everyone, so you should discuss each of these with your doctor if they arise as part of your birth. But we hope the following is useful in providing some basic framework for thinking about how they can impact your experience.
Pitocin: Pitocin is a synthetic form of the hormone oxytocin that is administered through an IV and is used to stimulate contractions in your uterus. The goal of those contractions is to ultimately lead to the dilation of your cervix and birth of your baby.
When your body is flooded with Pitocin, it actually ceases to release (or dramatically reduces the production of) the beta-endorphin, adrenaline, and oxytocin hormones. These hormones do some pretty incredible things: oxytocin is often referred to as the “love hormone” because it makes you feel good and promotes bonding with your baby, endorphins are your body’s natural pain relief and calming mechanism, and adrenaline boosts yours and your baby’s energy after birth so that you both have energy to begin nursing.
If Pitocin interferes with your natural supply of these hormones, it can result in increased stress and exhaustion for you and your baby and can result in increased use of epidurals (see below), which come with their own nursing side-effects.
None of this is game over for nursing, of course! It may just mean that you need extra encouragement, support, and help from a lactation consultant both in the hospital and after you go home.
2. Continuous IV fluids: For different reasons during labor you may find yourself with an IV providing fluids. These fluids, if given long enough, can cause some swelling in both you and your baby. If your breasts are swollen after delivery, which could result in some pain and more difficulty getting enough breast in your baby’s mouth, it could cause you stress and doubt about your ability to nurse. Additionally, any swelling your baby experiences as a result of an IV can result in an inflated birth weight and subsequent weight loss (water weight) in amounts higher than your pediatrician is comfortable with. This weight loss often results in the use of formula and bottles very early on, which can also contribute to a decrease in confidence in nursing as well as the number of feeds your baby is at your chest/breast.
An important way to combat this ripple effect and get nursing off to a healthy start is to work with a lactation consultant. Lactation consultants can do weighted feeds (weighing your baby before and after a feed to calculate how much milk your baby is getting) and provide guidance on what to expect with regards to weight gain for your baby.
If you do need to give your newborn a bottle, it may be helpful to practice “paced bottle feeding” by sitting your baby upright and holding the bottle at a horizontal angle, which lessens the pace at which your baby can transfer milk from the nipple. This can help with nipple confusion as you go back and forth between your breast and the bottle.
3. Epidural: Epidurals can impact early nursing in a number of ways. For one, having an epidural often means you also have an IV in place and can experience the swelling described above. Additionally, epidural medications can reach your baby in utero and can make them sleepier and less eager to feed after birth. An epidural can also lead to a fever in you or your baby, which may require monitoring of the baby, potentially eliminating or reducing your immediate skin-to-skin time after birth.
Immediate skin-to-skin and nursing within the first hour after birth are really important pieces of the start of a breast/chestfeeding journey, but do not be disparaged if you find yourself wanting or needing an epidural and experiencing any of these side effects. An epidural may provide the relief you need to have a positive birth experience, which is really important to your postpartum recovery. You should have no shame in requesting an epidural, just remember that you may need additional support from a lactation counselor if any side effects of the epidural impact your start to breast/chestfeeding your baby.
Above all else, we never shame a parent for opting to use formula - supplementing or switching to formula is never a “failure.” But every nursing parent deserves as much support and information they desire in order to have a positive breast/chesfeeding relationship with their baby.
This information is not provided to instill fear of these common interventions. Rather, we discuss all of these interventions in our classes to ensure that when you give consent to have any of these (or other) interventions introduced to your birth, you understand that there can be complications and side effects associated with them.
A difficult start to nursing can be discouraging and at times overwhelming for the nursing parent. But it does not have to be the end of that journey. The Breastfeeding Center of Greater Washington and the Washington, D.C. area offer robust support, including IBCLC lactation consultants, chiropractors, physical therapists, mental health therapists, postpartum doulas, and more who can help you when nursing gets tough!
Brave Birth Collective offers comprehensive childbirth education courses as well as individualized birth planning sessions to expectant parents in the DMV metro-area and beyond. Our philosophy is completely non-judgmental and we believe that every parent should have the information, resources, and support they deserve to make informed and personal choices about their pregnancy, birth, postpartum, and parenting journeys. No two birthing people or families are the same, and so informed decision making, self-advocacy, confidence-building, and empowerment is at the heart of our educational programs. You can learn more at www.bravebirthcollective.com