Embrace the Inevitable Change

The most frequent complaint I hear from mothers I work with is that every health care professional they encounter postpartum gives them conflicting information. What the delivery room nurse tells the mother to do is different than what the postpartum nurse tells her. Then, she sees both me and her pediatrician. And I tell her to do things differently than all three people she has spoken to prior to me! Add the opinions of her girlfriends who were and weren't successful with nursing, a few great internet sites, Kelly Mom and maybe Breastfeeding.com, and her mother in law. She is now thoroughly confused, frustrated and doubting her ability to take care of her newborn. It doesn't make for a good and confident start to breastfeeding!

And what if I told her that I suspected that every person who gave her that advice was probably correct? That each of them had nothing but good intentions, and really wanted to help her. Not possible right? But it is. And this is why. Babies change and they change rapidly. A newly born baby is very different from a three day old. A two week old is vastly different from a baby that just hit six weeks. A four month old is different than a three month old. If you keep feeding that four month old every 2-3 hours like you are told to do in the hospital, your family is going to be very frustrated.

So how does a smart but scared new mom handle all this conflicting information? Start by giving the benefit of the doubt to everyone you encounter. Be positive and assume that they all have good intentions. Then, remember that breastfeeding and mothering is an evolving process and embrace the inevitable change. Know that just when you think you have your baby figured out, he is going to change on you. And change is good! Do you really want to be waking a baby to eat every three hours for months on end? Of course not! Eventually you want to sleep through the night again, right?

Please try to remember that every healthcare professional you encounter, including me, is giving you advice for that particular moment in time, based on their assessment of your situation. Websites and books tend to give excellent evidenced based information, but it is very general. Girlfriends, mothers and mothers-in-law tend to have biases based on their experience. All this information has to be filtered in the context of what is going on with your family and whether it makes sense to you. And is it working? If you are doing something but both you and your baby are miserable, why do it?

Two excellent books that help with this common frustration are The Nursing Mother's Companion, by Kathleen Huggins RN MSN, and the Touch Points book series by T. Berry Brazelton MD. I like to call the first book the What to Expect When You Are Expecting of Nursing! The author breaks down the newborn period into very specific time frames, and gives excellent anticipatory guidance about normal challenges you can expect and how to handle them. It is a very realistic and reassuring book for a new nursing mother, and something you will refer to the entire time you are nursing.

The Touch Point books have little to do with nursing, and are more about normal developmental milestones that all children go through. Dr. Brazelton writes that just before a child is ready to jump to the next level developmentally, there is a period of chaos in the home. He calls this time a "touch point." He writes, "Touch Points, which are universal, are those predictable times that occur just before a surge of rapid growth in any line of development-motor, cognitive, emotional-when, for a short time, the child's behavior falls apart. Parents can no longer rely on past accomplishments. The child often regresses and parents lose their balance and become alarmed." However, once the parents realize their child is ready for something different, and go with it, peace returns to the household. That is until the next touch point hits!

So, what is a new mom to do with all this conflicting information? First and most importantly, take into consideration where your baby is developmentally. Then, decide if you trust the source. Lastly, think about whether the advice makes sense to you. If it does, try it. If it doesn't make sense, or you try it and it doesn't work, try something else. But don’t change anything that is working for you, based on something someone else says, even me! And when you make a change, make only one at a time and try it out for a bit. If you make too many changes at once, you won’t know what works, or doesn’t. If you take the approach that the only constant in life is change, and filter all this information through the guidelines mentioned above, you will be confident in your ability to care for your baby!