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Sharon Tenuta

Baby-led Breastfeeding Stages


Baby-led breastfeeding
smiling baby at breast


I am an advocate for breastfeeding for newborns.  If babies survived for centuries without formula, there is a reason that they survived.  Mother’s milk, in normal situations, is the best for a newborn.  It contains just the right amount of nourishment, with the right size of molecules, and the right amount of fat and sugars that the baby needs right from the beginning of life. 


When the baby is born, the stomach is about the size of an almond.  It does not require much to fill that baby stomach.  As baby adjusts to earth life, the stomach grows.  Mother’s milk comes in according to the baby’s interaction with mother’s breast as well.  If it is massaging the breast, and snuggling with mother, the oxytocin hormones interact with the prolactin and also with baby’s stomach digestive hormones.  More milk is made and baby’s nourishment needs is registered with mother’s body. Her body adjusts accordingly.


We often pick up baby and just put baby on mother’s breast right after birth.  However, I discovered in a webinar that there are nine stages for the baby to pass through for the physiological process of successful baby-led breastfeeding.  I compare this to the nine steps of the breast crawl, that I had previously learned from Karen Strange.


These are the nine stages of baby-led breastfeeding initiation.

               First, baby cries, showing its desire to survive.

               Second, baby has a relaxation stage when on mother’s chest and hearing her heartbeat.

               Third, baby awakens and starts to root and move the hands and head around.  Eyes open.

               Fourth, Baby’s tongue protrudes and baby becomes active in moving its head, trunk and arms. 

Baby smells the Montgomery glands of mother’s nipples.

               Fifth, there is resting all throughout the stages.  Baby does something and then rests several times.  It is important to be patient with these rest stages so baby does not need to start over.

               Sixth, is a crawling stage.  This is crawling on mother, and between the breasts. 

               Seventh, for about 20 minutes, baby will lick the breast, shape the nipple, and areola. Wait, especially if you have an inverted nipple.  Baby can help reshape it to its liking.

               Eighth, the newborn successfully suckles.  Chin first contact is associated with a deeper latch.

               Ninth, after about 1.5 hours of suckling, baby will become drowsy and fall asleep.

 

These are the wait and observe clues for baby-led breastfeeding for the 9 stages to baby-led breastfeeding normalcy.  Things that should not be done during this first part of baby’s life include the following list.


               First, do not suction baby’s mouth, this can disrupt the cellular level normal drive to live.

               Second, do not separate baby from mother.

               Third, do not move baby to mother’s chest.

               Fourth, do not wipe baby’s amniotic fluid and vernix off.

               Fifth, do not separate baby from mother, even if resting and quiet.

               Sixth, do watch baby so it does not fall off of mother or the bed.

               Seventh, do not rush and help baby finish the process.

               Eighth, Do notice if baby’s chin touches breast before baby latches.  Don’t help at this stage.

               Ninth, do not wake baby from the long sleep that awaits.  Some babies will sleep 5-6 hours.  This first long sleep time is ok.  After this initial sleep, baby will normally breastfeed every 2-3 hours.


Benefits of patiently waiting for baby to initiate breastfeeding include earlier expulsion of placenta, little chance of hemorrhaging, lower level of stress for mother, a natural release of oxytocin, mother’s greater sensitivity to the needs of the newborn, and a start of a solid relationship between mother and baby.


This is the summary of what I learned about the 9 stages to baby-led breast feeding normalcy.  For more information, check the website of Tanya Singleton, BSN, MA, MPH, RN-BC, IBCLC, LCCE, DFB.  She gave an excellent presentation with Midwifery Gold, Fall 2024.  In Touch and In Tune also encourages you to check out the Intouch and Intune website for more information in regards to midwifery, and birth care.

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