BREASTFEEDING:
“CULTURE VS. NATURE”
BIRTH
• What happens at birth?
• What impact do interventions have on
birth/breastfeeding?
Syntocinon Induction
Epidural
Instrumental delivery
Caesarian Section
AT BIRTH:
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Vaginal vs. caesarian
Separation
Baby’s senses
Timing / clock watching
Hormonal influences
Skin-to-skin: When? How? Why?
CACHE MAMMALS
• Deers
• Rabbits
• Mature at birth
• Hidden for up to 12hrs
• 12gms/L protein
• High fat
FOLLOW MAMMALS
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Mature at birth
Follow mother
Feed often
4gms/L protein
Lower fat content than
cache mammals
NEST MAMMALS
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Less mature at birth
Nest for warmth
Remain with others in litter
Feed several times a day
10gms/L protein
High fat content in milk
CARRY MAMMALS
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Immature at birth
Need warmth of mothers body
Carried constantly
2gms/L protein &  fat
Feed constantly
“SKIN TO SKIN” CONTACT
 Humans are mammals!
 Skin-to-skin contact is a ‘Carrier’ mammal behaviour
 Mothers chest wall is built for babies! Warmth food and
protection
 When born vaginally the baby is exposed to the mothers
pathogens for which she has the antibodies. Babies born by
caesarean section are at an increased risk of asthma
 The release of oxytocin increases the temperature of the
maternal chest wall and helps with the bonding process
 Stabilizes respiration, pulse, blood pressure and temperature
INITIATION
 Breastfeeding is a basic instinct: programmed in the hindbrain
 Breastmilk immunoglobulin: is mother specific: Formula
feeding a baby from birth means the baby is not exposed to
the antibodies found in the mother’s milk – some of which
have been passed down two generations.
 Smell and taste of colostrum is unique to each mother
 Oxytocin found in mother’s milk is a sedative and a relaxant
and can assist the baby to recover from the trauma of birth.
INITIATION
Separation = stress
The baby is less stressed in skinto-skin contact – cries less –
therefore the blood sugar is
more likely to be stable
Stress hormones can be
identified in a baby separated
from its mother – drop by 74% if
returned to its mother.6
- not influenced by culture or society. Breastfeeding is an inborn
programme in the hind-brain
- human babies are born to breastfeed as are all mammals.
This baby is a “stoneage baby” in a “space-age world.”
Are we nurturing our babies in a ‘mother-led’ or ‘baby-led’ environment?
If the babies could choose ………. ?
The Breastfeeding Dyad:
Mother and baby – belong together. Do not separate mother and baby.
SO LETS RECAP……….
Anatomy and physiology
Culture versus Nature
ANATOMY
• Shoe size? Hat size? Breast size? – we are all
different!
• Breast capacity depends on glandular tissue
• 4 types of mammals: carry vs follow
• Baby knows no different.
FACTS
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96% of breasts ‘work’
95% women in New Zealand initiate breastfeeding
Breast capacity – variable
Feeding frequency – variable
Duration Intensity and frequency of feeding
If left together the baby and the breast work it out
together:
Mother-led or baby-led or society-led?
Cue-based feeding is the gold standard.
IN A BOTTLE-FEEDING CULTURE WE
MUST REMEMBER:
• Breastmilk is designed for optimal growth
• Loss of knowledge of natural breastfeeding makes
mothers doubt themselves!
• Stop comparing breastfed babies to formula fed
infants
Growth charts
Sleep patterns
Feeding frequency
• Women must stop comparing themselves with
others!
An exclusively breastfed baby is the norm.
NATURE
• Only time in history a woman has had so few babies
and breastfed so little!
• The female was once either pregnant or
breastfeeding during her fertile life (often both)
• Hormonally our bodies are now ‘different’ – more
likely to be anaemic, (due to  menstruation) and
increased risk of hormonally controlled cancers.
CONCLUSION
Culture or nature?
• Often mothers want their babies to
feed four hourly and to sleep
through the night. Breasts and
breastmilk invariably do not work
this way.
• Only 1-4% of breasts fail to produce
sufficient breastmilk# – sadly women
trying to fit their feeding into the
lifestyle of modern culture readily
blame their breasts:
• “My milk is too thin.”
• “I don’t have enough milk.”
• Unlimited access to the breast
ensures adequate intake in 96% of
cases – the breast and baby work it
out together.
• Interference in this fine balance
may compromise the breastfeeding
outcome!
REFERENCES
1. ‘Computerised Breast Measurement from Conception to Weaning: Clinical Implications’
Creagan MD, Hartmann PE. Journal of Human Lactation 15:89 (1999)
2. ‘Suckling behaviours and growth rates of New Zealand fur seals, Arctocephalus forsteri,
at Cape Foulwind, New Zealand’ Chilvers BL, Wilson K-J, Hickling GJ. New Zealand
Journal of Zoology; 30 March 2010
3. ‘Delivery by Cesarean Section and Early Childhood Respiratory Symptoms and Disorders
The Norwegian Mother and Child Cohort Study’ Magnus MC, Håberg SE, Stigum H,
Nafstad P, London SJ, Vangen S, Nystad W. Am J Epidemiol 174 (11): 1275-1285
(2011)
4. ‘Chemosensory Development in the Fetus and Newborn’ Browne JV. Newborn and Infant
Nursing Reviews. Vol.8 Number 4 (2008)
5. ‘Early skin to skin contact for mothers and their healthy newborn infants’ (Review)
Moore ER, Anderson GC, Bergman N. Cochrane Collaboration (2009) Issue 1
6. ‘Public Health Implications of skin-to-skin contact’ Nils Bergman; powerpoint
presentation (2012)
7. ‘Breast Anatomy’ Breastfeeding Answer Book (Update) LLLI March 2012
8. ‘Skin-to-Skin Information’ (pamphlet) NZBA 2010
9. ‘Just a few breastfeeding bits and pieces for your interest!’ Team Hartmann 2005