Letting baby do the work: Biological Nurturing
It was late afternoon on a dark November day and I was at the end of my tether. Week 6 of breastfeeding and I was wincing with pain every time my baby latched on. The doctor had diagnosed thrush and prescribed a cream for me, instructing me to express all feeds until I am ‘better’. Luckily I’m not one to accept things without questioning and this diagnosis rang alarm bells. Surely, if it’s thrush then my baby would also show signs of it? And what would be the point of treating me without treating my baby? Logic kicked in. This can’t possibly be right.
I sat in my pyjamas and pondered what to do. Believe it or not, since giving birth this was the first time I’d not managed to get dressed by lunchtime – things were obviously bad! Fed up with the constant pain when feeding I started to resent my baby as if she was hurting me on purpose. I dreaded every feed. The only option seemed to be to give up breastfeeding.
Thoroughly confused and worried, I decided to call the NCT Breastfeeding line. A counsellor talked me through the problems I was having and she agreed that I shouldn’t accept the doctor’s advice. She suggested that it was a problem with the latch. I’d religiously followed the ‘nose-to-nipple’ mantra – what more could I possibly do?
“Have you tried biological nurturing?” she said.
I hadn’t. It sounded like a washing powder.
Biological nurturing – what is it?
Biological nurturing is often described as a ‘new’ approach to breastfeeding. It wasn’t discussed in my antenatal classes and most people I mention it to have never heard of it. The technique is based on a baby’s natural instinct to search for the breast when hungry – the adorable and relentless ‘pecking’ they do to any shoulder they encounter. Letting your baby search for the nipple by themselves is said to be the best way to get the most natural latch. No need to direct them or tip them this way and that, just let them make their own way towards what they’re after: hence why it’s also called ‘breast crawl’ or ‘baby led attachment’. This newborn instinct is said to lessen from around 6 weeks of age so if you want to try this technique, it is recommended to do it sooner rather than later.
“I did have an experience of this one morning when my baby was about 4 weeks old. We were lying in bed and he was sleeping on my chest, the next thing I know he had wriggled up to my boob, latched on a perfect latch and had a really good feed. I had an over supply of milk for a long time and usually had to express a few ounces before each feed (which also used to choke him at the start), but I was really amazed that this didn’t happen on this occasion. I never realised that this was the biological nurturing method or I would have explored it further. I remember being really amazed at how such a small baby could find his way to food instinctively.”(B, mum to Adam)
The turning point
A couple of hours after my call to the NCT line I settled myself on the bed with my daughter for her feed. I remembered what the counsellor said and took a deep breath. I couldn’t believe it. There was no pain. No tears. No gritting my teeth. My baby had latched on like a dream.
A simple technique
I found the ‘rules’ for getting a good latch in the traditional cradle position really hard to get right. Trying to remember where my baby’s nose was pointing, whether ‘tummy was to mummy’ and where her chin was resting left me tense before I’d even started. Biological nurturing was described to me in a matter of seconds and I didn’t need diagrams.
3 easy steps
STEP 1: Sit back and relax.
STEP 2: Lay baby lengthways down your chest with their head between your breasts.
STEP 3: Allow baby to wriggle to the nipple, guiding and supporting them as necessary.
If it needs a mantra then it’s ‘chest to chest, chin to breast’. The appearance of a good latch is as with other positions: mouth over plenty of the areola, chin to breast and nose clear. Like any method, it does still require a little trial and error. Biological nurturing relies on using a baby’s natural ability to find the breast to maximise the chances of a more natural, more comfortable latch. It is thought that by allowing the baby to attach itself, it increases the chances of it taking to breastfeeding more easily thus avoiding some of the problems that mums can have with feeding in the early days. Of course, with something as personal as breastfeeding, mums find what works for them and their baby. Biological nurturing was something simple that worked for me.
“My baby has a preference for my left boob and I can spend 20 minutes trying to get him latched on my right but with this method he wiggled himself down and latched on perfectly all on his own! He is three weeks old today and last night was one of the best nights we have had as it was so relaxed not fighting each other to get a good latch.”(M, mum to 3-week old)
The science bit
I wanted to write this based on my personal experience rather than trawling through lots of research. However, the ‘science bit’ is fascinating. A baby’s tendency to search for the breast is a ‘primitive neonatal reflex’ (PNR). This is a spontaneous reaction to stimuli that is innate rather than conditioned or taught. Left to do so, a newly born baby has the ability to find its way to the breast within an hour, provided it has not been affected by drugs administered to the mother during labour. Research suggests that the feeding positions recommended for biological nurturing encourage these natural reflexes to emerge. This is how Dr Suzanne Colson, probably the most prolific advocate of the technique, describes the results of early research:
“The key components of BN [biological nurturing] were a range of semi-reclined maternal postures … These appeared to act in synergy …which appeared to maintain close mother/baby body contact enhancing the expression of PNRs, facilitating … infants to find the breast, self attach and feed even whilst asleep”. *
Dr Colson concludes that:
“…[t]his study… challenges the effectiveness of established maternal breastfeeding postures where the focus of consistent advice is skills teaching within a fixed system of positioning and attachment.”
The suggestion is that the more upright positions mothers are taught to adopt, for example with the cradle position, don’t encourage the baby’s natural reflex to latch on in the way a reclined position does. This leads to a question: how can biological nurturing be a practical technique that is flexible enough to suit a mum’s normal everyday routine?
Not as impractical as you might think
Biological nurturing is often discussed as a technique for establishing a latch in the early days and for bonding. The mother must be reclining and skin to skin contact is encouraged. Some advocates overplay this aspect and thus portray the technique as one that is only practical in your own home, in bed and in private. It is therefore often dismissed as impractical. Yet it is a technique that can be used throughout your time breastfeeding. Even though a baby’s natural instinct to root may lessen, you will by that time have established a comfortable feeding position of your own grown out of baby led attachment. When I first tried biological nurturing, I was indeed semi-reclined and semi-clothed – the ‘prime’ conditions according to medical and scientific experts. Following that first attempt, I soon moved to a more upright position, continuing to utilise the principles of letting the baby lead. Who am I to question science, but it still worked!
Can I do it when I’m out and about?
The short and encouraging answer is yes. It isn’t necessary to have skin-to-skin contact or to be semi-reclined. Neither of these would be appropriate in a public place even for the most liberal of mums! Sitting in a chair, I simply placed my baby’s legs either side of one of my legs and aimed her in the direction of the breast on the opposite side of the leg she was straddling. That way she was more or less in a vertical position and easily held. In fact, if left to attach on their own, most babies do adopt this diagonal position. Even with a big and long baby, this position proved immensely comfortable and practical. The key is to use the basic principle of biological nurturing – the baby’s self-attachment – combined with what is practical and works for you in the environment you’re in.
“The bottom line is that you have to be relaxed for breastfeeding to go well and most situations – in hospital, with people watching and barking instructions, sitting up in uncomfy bed, feeling tense, still sore from birth do not encourage this to happen as naturally and easily as it should.” (L, mum to Emily)
Breastfeeding may be a natural process but it isn’t the most natural thing in the world to get right. It’s not easy and no one should ever feel a failure if they struggle with it or decide to stop. Finding a position that is comfortable is vital to success: relaxed mum, satisfied baby, victorious breastfeeding! Biological nurturing proved a simple solution to the particular problems I was having and made breastfeeding click into place when it seemed impossible to carry on. This technique should be added to every mum’s toolbox for successful feeding.
*‘The Mechanisms of Biological Nurturing’, Dr Suzanne Colson, http://www.rcn.org.uk/search?q=colson
www.biologicalnurturing.com – Dr Suzanne Colson’s website.
www.breastcrawl.org – includes an amazing UNICEF/World Health Organisation (WHO)/World Alliance for Breastfeeding Action (WABA) film: http://breastcrawl.org/video.htm.
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