Note: This post is the sixth in a series chronicling the adventures of an American having a child in China. If you haven’t been following, you can start at the beginning of the series here.
The Art of Suckling
If you think breastfeeding comes natural to a mama, think again. Mother and child have to learn how to move together and that takes some practice. For most mamas, the first week or so of breastfeeding is painful and frustrating as well as extremely rewarding when the baby finally suckles properly.
Both mama and baby react instinctually to the baby’s hunger: Mothers begin producing milk within the first 3-5 days after birth and baby’s are equipped with a rooting reflex, suction cup lips and a pair of healthy lungs to notify everyone when hunger strikes.
Problems arise when the positioning or latch are incorrect. A baby has to be lying in the right position to suckle and the baby’s mouth has to be latched onto the areola in the right position to avoid hurting the nipple. There are many different types of positions for the baby to lie in (cradle, football, lying side by side) but the main idea is to line the nipple up with the baby’s nose and have the baby’s mouth open wide and latch onto the brown area around the nipple (areola), not onto the nipple itself.
The Latch is the key to breastfeeding and it sounds simple, but when we went to get our Permission to Give Birth Certificate, there were classes on breastfeeding and positioning in which the instructor used a doll to demonstrate the correct positions. Dolls do not scream, flail, kick, lunge, swerve, twist or any other movement that all one month olds are capable of doing when hungry. Not only will a baby twist and squirm, but if he is truly hungry, then he will launch his face at the nipple mouth-first and clamp down hard on anything that tastes like mommy. I am sure some of you men out there are aware how sensitive a woman’s nipples can be.
When the latch is incorrect in some way (ie, mouth not wide enough open, nipple not deep enough inside the mouth, sideways or any other weird error) then pain and frustration ensue. The pain of a nipple-chomp can be mind numbing and the frustration arises from the desperate wailing of a hungry baby and the fevered attempts of the mama to get that nipple in there without losing it.
Negotiating Cultural Differences
In China, one of the phrases I hear the most concerning breastfeeding is, “You don’t have any milk, right?” There seems to be an “expectation” that the mother will not have enough milk for the baby. The nurses that I encountered at No. 9 Hospital said repeatedly (on the first day!) that Xiao Bai would probably not have any milk for the baby and therefore we needed to use formula. Old women that stop by to check out the Mixed-Breed are always shocked to hear that Xiao Bai is dripping milk like a leaky faucet.
This attitude is in keeping with other things we have experienced at hospitals here, such as the reliance on caesarian sections, and we face them down the same way I faced down the first nurse who demanded we stuff our newborn with formula on day one. But what that unfortunate reality means is that resources for the breastfeeding Chinese mama are scarce. They have to rely on their own mothers and grandmothers (who often subscribe to traditional methods and tend to view the words of the hospital as the Gospel) or on friends. Networks like Chengdumama and the traditionally strong Chinese family structure tend to be enough to keep the mama and baby healthy in the first few months.
That being said, most Chinese clinics will provide skillful breast draining for a very low price. This can be a lifesaver. The nurses, although unclear as to why they are draining a breast or how to make themselves irrelevant by teaching proper breastfeeding techniques, nevertheless are great breast drainers. Many local women take advantage of this service in the first month or two, before they learn how to take care of themselves.
In the US, there are midwives and breastfeeding experts at most clinics that help out with latching and other issues and, most importantly, in American hospitals women are urged to give the baby the breast immediately after birth to get him used to it, calm him down and to stimulate milk production.
La Leche League, an organization dedicated to promoting and encouraging breastfeeding, has offices and representatives in many parts of the world and all over the US. Their website has a lot of very good information and it is possible to contact a representative near you for further advice. Unfortunately, LLL does not have a branch office in Mainland China that is up and running, but we were able to glean important bits of information from their website and other online resources like KellyMom, Babycenter and Breastfeeding.com.
We used these sites to find out important things such as the fact that suction stimulates the milk supply and it is important to not only get some suction going, but also to empty the breast as the body will then respond with increased production to meet increased demand. If the breast remains filled not only will production increase slowly, but the risk of infection and/or blockage of the milk ducts increases.
So in the past month, Xiao Bai bravely faced down three separate cases of masititis, which is an infection of the breast ducts. Very painful. Can bring on a fever. Requires a forced draining of the breast via vigorous and skillful massage. There are a few things that bring on this type of breast infection:
- Milk is shooting out faster than the baby can suck it down, resulting in some milk re-entering the duct. The body considers this milk to be a foreign protein which it then attacks with white blood cells, rising temperature within the breast and as a last resort a fever.
- An undrained breast clogs up, whereupon the body reacts in the same way
- A perfectly normal and drained breast clogs up, resulting in yet another fever.
The only ways to treat masititis are antibiotics and draining. But, there are several ways to avoid all of this:
- Repeatedly breastfeed your child
- Drain what the baby does not drink with a breast pump or by hand
- Massage and drain your breast by hand regularly
- Put a very hot wet towel on your breast regularly
- Drink water on a regular basis
Much of this has to be done alone or with a band of women friends. I have drained my lady’s breast, cleaned the pump, ran for more water, held a screaming baby and many other things so I can attest to the usefulness of men in such womanly situations. Now you’ll have to excuse me as I return to my month-old child and recuperating wife.
Thanks for reading! I’d love to hear what you think in the comments. The next post will deal with the hardship of buying medicine, formula and other needful things in China without poisoning your baby.