​Breastfeeding is a ‘Mothering’ experience and is also a tool that makes life of a mother far more simpler, natural, sustainable & lowtech. Looking after a newborn baby is an intense experience during the first months of life and is usually 24 hours on duty as a young mother. This can sometimes mean being sleep deprived. Here I share with you how breastfeeding supports better circadian rhythms for mother, baby and father making this intense journey into a smooth and supported journey.
 
Breastfeeding allows the mother to remain restful in a biological nurturing position on her bed and nurse her baby providing her the much needed rest and sleep. Here are some ways on how you can facilitate this position:
 

1. Set up a firm pillow backrest in the middle of your bed to create a 45 degree easy chair like backrest recliner or simply use a recliner.
2. Lay back and place baby on the mother’s abdomen. If the mother has had a C-section, it will help to use a padding like a rolled bed sheet or a small cushion on the lower abdomen.
3. Laid-back breastfeeding or this biological nurturing position is about using positions that tap in to your baby's natural reflexes. Babies are born to be most comfortable in this position. Many mothers find babies latch much deeper and receive much need skin to skin contact.

 
Mother’s milk is a living fluid and its complex dynamic fluid interactions are amazing and stunning. Breast milk undergoes biochemical changes during a feeding as a potential source of certain nutrients to her baby at different times of the day. All this is in synchronicity with mother’s circadian rhythms. Additionally tryptophan is released in the mother’s milk while baby suckles at mother’s breast. This tryptophan helps produce melatonin which makes baby feel drowsy and often “Milk Drunk”.
 
Therefore babies who are growing well on exclusive direct breastfeeding falling asleep at the breast is normal and desirable. This is often debated as supporting “bad habit” formation by some who believe attachment parenting is harmful and make children clingy and dependant. Infact a breastfeeding mother cosleeping with her baby can easily feed her baby without having to wake fully, and can continue to get her sleep and baby sleeps better too. Cosleeping helps maintain a mother’s milk supply.
 
However, babies who are sleepy at breast and not gaining well are compromising on ineffective suckling and therefore inadequate intake. This is a flag that needs to be investigated and supported by your Lactation Consultant.

​All babies have primitive reflexes to crawl on mothers’ breasts to find the nipple and latch and feed. This process is natural and inherent competency of every baby and requires little help. However this process may seem like it needs expert help and support owing to unsupported brith and breastfeeding during early days after birth.
 
Start Right:
 
Providing safe & gentle birth is perhaps the biggest factor to get breastfeeding to a great start. This means non mediated birth and working towards no separation of of mother and baby. It is perhaps is best to allow mother and baby to find an intuitive bonding space which will allow the natural responses to emerge and begin and establish frequent feeding rhythm. This allows the baby to be guided by the smell, touch skin to skin contact and eye contact with mother to establish feed and sleep cycle.
 
Basic guidelines to help a mother feel encouraged:
• Position and latch is an interactive process and allowing the mother to find her comfort is very important.
• Each mother and baby has a unique relationship.

• Every baby needs to be supported for structural stability to be able to latch comfortably.
• Apart from regular breastfeeding position there are innumerable creative positioning that are therapeutic positions to help unique challenging breastfeeding situations.

 
Laid-back breastfeeding or Biological Nurturing:
The most natural position to help mother and baby elicit this rhythm behaviour is called a laid-back breastfeeding position or reclined breastfeeding position. This chest to chest skin to skin contact helps self-attachment  to the mother’s breast.
 
Guide to Laid Back Breastfeeding Position:
 

• The mother leans back in a semi-reclined 45 degree position so that she is completely comfortable and aligned.

• She is her back and her arms are well supported under two comfortable pillows.
• Baby is placed skin to skin on mothers chest.
• Baby’s torso body (Chest and abdomen) is in full contact with the mother chest and abdomen.

• Baby’ moves towards the mother’s breast with a baby’s head bobbing and using baby’s cheek contact on mother’s cheek the guide towards nipple.

 
Guide to Cradle Hold:
 

• Mother sits with her back straight.
• A nursing support pillow may be helpful during the early days to provide support to baby and mother’s  hand.
• Mother places baby on her lap such that baby’s abdomen is aligned with her abdomen.
• Mother supports the baby’s head, neck and shoulders in the cup of her palm and tucks baby lower bottom into her curve of her waist.
• Mother supports her breast with a C hold with her inner and and supports baby head under her other hand crook of her arm.

 
Guide to cross-cradle position:
 

• Mother sits with her back straight.
• A nursing support pillow may be helpful during the early days to provide support to baby and mother’s  hand.
• Mother places baby on her lap such that baby’s abdomen is aligned with her abdomen.
• Mother supports the baby’s head, neck and shoulders in the cup of her palm and tucks baby lower bottom into her curve of her waist.
• She then supports her breast with a C hold with her outer free hand and guides the baby lower chin to touch mother’s breast and encourage baby to open jaw widely to take a deep latch.

 
Guide to Football Hold:
 

• Mother sits with her back straight.
• A nursing support pillow may be helpful during the early days to provide support to baby and mother’s  hand. Place the pillow behind the mother on the bed.
• You cradle the baby's head in your palm with baby’s abdomen against yours, keeping him in line with the rest of his body
• Mother supports the baby’s head, neck and shoulders in the cup of her palm and tucks baby lower bottom into her curve of her waist.
• Mother supports her breast with a C hold with her outer free hand and supports baby head under her other hand crook of her arm.

​Breastfeeding is a universally accepted means of optimal nutrition that promotes a baby best survival, growth and development. World Health Organization (WHO) recommends that babies be exclusively breastfed for the first 6 months of life with continued breastfeeding up to 2 years of age or beyond with adequate complementary feeds. While emotional support by family, society or hospital or government policies are crucial, one of the most significant impact on initiation & establishing of breastfeeding is how Breastfeeding is planned during conception & how birth has been supported.
Breastfeeding can be a powerful and compelling experience for a mother and her family no matter how different their conception experience maybe — Natural Conception, Assisted Conception such as IUI or IVF, Surrogacy or Adoption. Planning for Breastfeeding can differ depending on whether the conception is natural or assisted.
Breastfeeding preparation following Natural or Assisted (IVF) Conception:  
During pregnancy mothers wish to prepare to welcome their baby and ensure they spend enormous amount of time into researching and organizing their home and family to make way for a comfortable beginning of a family. Often breastfeeding is not on the research beyond just basic reading of the importance of breastfeeding or amazing benefits of breast milk. Here are some of thought to consider and prepare for a head start in breastfeeding:
Planning your birth
One of the most crucial aspect of natural progression of birth into breastfeeding is ensuring the experience of the birth to be as gentle and as supported as it can be. For breastfeeding to initiate naturally the following factors appear to be crucial during labour & birth:

1. Natural initiation of labour with reduced use of labour induction, augmentation with drugs.
2. Gentle & loving support for a labouring mother and trusting her body’s inherent guidance for movement during labour and during birth. Allowing her to eat, drink and movement is critical for easy and natural rhythm of the labour.
3. Reduced use of pain medication such as epidural and other drug-based pain management techniques. When a mother innate body movement is allowed to progress the birth with a non-intrusive watchful eye of attending midwives, nurse and doctor, the need for pain medication has shown to be reduced or eliminated significantly by overwhelming scientific research and by traditional midwifery knowledge.  Skilled Doulas and Midwives are known to significantly reduce need for medication and natural progress of labour and birth.
4. Reduced use of instrumentation such as Forceps, Vacuum, or surgery during birth unless it is to save the life of mother and/or her baby. Again the inherent body wisdom guides a mother to move to facilitate the baby descend in the birth canal along with natural reflexes that help a mother birth her baby. This wisdom needs to be enhanced, supported and initiated to be elicited. When this wisdom us ignored and damped, need for instrumentation may be required and the impact could be muscular & tissue tension pattern     
5. Immediately initiation of skin to skin direct contact between mother and baby and over the first few weeks of life - There is overwhelming evidence of research that demonstrates skin to skin contact immediately after birth, reduced distress in a baby and keeps the baby’s heartbeat, breathing, temperature more stable including baby’s blood sugar is stabilised preventing hypoglycaemia or new born jaundice. Furthermore, skin to skin contact also helps baby to receive same good bacteria as the mother. 
6. Early and uninterrupted contact between mother & baby helps initiate all the primitive reflexes baby needs to move towards mother’s breast and latch and feed ensuring good milk supply for the weeks, months and years to come.

 
Creating a support system:
 

• Finding a shared commitment to mothering through a groups like La Leche League Monthly Meetings, Breastfeeding Support Group for Indian Mothers (BSIM) or even online breastfeeding support groups can be great help to create a safety net for emotional support and sometimes it can be the only help for encouragement for breastfeeding.
• The Womanly Art of Breastfeeding by La Leche league International is a great book to have for every mother who wishes breastfeeding her baby.
• Connecting with a Lactation Counsellor during the hospital stay or a private lactation Consultation in the community can be enormous help.

 
Invest in Baby Wearing:
Instead of designing a nursery for the baby, mothers find it helpful to invest time and preparation in learning to baby wear in fabric slings. Baby wearing can be an easy way to meet babies need for warmth, closeness and breastfeeding. A hand free of caring for a baby can enhance early motherhood and reduce mothers fatigue and overwhelm.  

It is increasingly becoming common to find single-parent families globally. Most of these families are headed by women. Between earning a living, child rearing — breastfeeding can pose a unique challenge to these young single mothers. Add exclusive breastfeeding to this & the challenge it can pose can be easily be overwhelming to say the least.
Some of the most important challenges that will stand out to a exclusively single breastfeeding mother are:

Nurturing & Self-Care: One of the most neglected for all young mothers is self-care and recovery from childbirth in today’s time. This is where Traditional wisdom has always strongly guided communities across the world with postpartum rituals and routines of caring for a young mother nourishing and nurturing her with herbals routines and traditional warm foods. In modern times these practices are eroding and especially the single mothers may miss them completely. Therefore seeking postpartum services or any help from family or friends to allow a period of rest and nourishment can be helpful. Always keep a bottle of dry nuts and seeds. These provide packed energy anytime with no preparation.


Night Feeds & Baby Care: are the most exhausting for young parents. It is desirable & normal for a baby to feed a couple of times during the night and often milk producing hormones are on a surge during the nights. Not having help around can be extremely overwhelming especially if a baby is being bottle fed. Exclusive breastfeeding can provide more rest for the mother and baby. Co-sleeping on the same bed can make it easier to support exclusive breastfeeding and keeping baby close provides deep bonding and responding to baby’s natural cues of hunger and other needs a lot easier.    


Planning is the key: In urgent situations, it’ll be hard to run out and get medicine since you can’t leave your baby home alone – and you might not want to take them with you to the pharmacy in the dead of winter at three in the morning. Make sure to have extras of everything you might need for emergencies. Once you’ve done that, it also helps to have extras of non-emergency items so you have everything you need on hand.


Staying honest to priorities: Being a single mother means having to manage all baby care, finances, home care and other needs all alone with no partner to share responsibilities including handling emergencies. Keeping the list of priories and absolute musts is critical to have stress-free days and keeping calm to provide an emotionally safe environment to baby. Accepting help can give you an opportunity to even just have a bath or comb your hair or have a meal.

​
Building the ecosystem & community: Many people want to help, but are unsure how to best support you or where to even begin helping. Listing down matters those need attention pass them onto when someone asks how they can help. Joining regular mother to mother support groups like La Leche League International or Breastfeeding Support Group for Indian Mothers (Online Facebook Group) 
Use of Technology: From mother support groups such as BSIM or online shopping, sometimes technology can help in significant ways to reduce stress.  Saving you immense amount of energy.
Yoga Nidra: Nidra or sleep is an ancient practice to calm your nervous system and resource you immensely physically and emotionally. All it requires is rest.  Here is a quick access to the Nidra Guidance which is soothing and resonating. You and your baby can feel deeply supported listening to it everyday. Listen to yoga Nidra. Nothing to do, just lie in bed and listen. This is facilitated by Mirabelle D'Cunha! Take your pick from Hindi & English (https://youtu.be/ASH5t6-cYSA / https://youtu.be/QI8WcXjej84)
You are surely never alone ! Always know you are never alone in this. There is always help just a call away either in your circle of friends, family, Lactation consultant or counsel, Facebook group or even mother to mother support groups.
 

​First Golden Hour
 
A newborn has an innate ability to survive and thrive if we allow the primal reflexes to kick-in as a sequence during the birth of the baby.  During a safe and supported birth within an empowering birth environment, the newborn often undergoes a quiet alert phase, which has been referred to as the first phase or simply the Breast Crawl.
 
When the newborn is placed skin to skin on the  mother's breasts chest shortly after birth, baby is able to move closer to the breasts and attach to the mother’s breast and initiate suckling. Studies show us that baby’s alertness gradually decreased within 150 minutes after birth, when baby usually becomes more drowsy & sleepy. This confirms the importance of first golden hour being critical to allow integration of many sensory, motor and neuro-endocrine inputs to facilitate a ‘Breast Crawl’ soon after birth. This helps mother and baby deeply bond in a natural, undisturbed way and maximise the opportunity for the baby to prime the milk receptors to stimulate and increase milk production for the mother for the natural term breastfeeding.
 
During the Breast Crawl Babies uses all senses to explore that world of bonding. The smell of the dark potion of the breasts is similar to the amniotic fluid which guides in the movement along with eyes to look at mothers' face, ears to hear her reassuring voice.
The first golden hour Breastfeeding is also a boost to mother ability to improved breast milk production and facilities in loss of blood.
 
First 6 Months
 
Breastfeeding is a normal natural way to provide growth and development both nutritionally and physically of babies. The official statement by multiple breastfeeding advocacy organization in the world recommend exclusively breastfeeding for the first six months of life to support optimal growth, development and health. Complementary food is recommended to be introduced, mostly around the middle of the first year to support baby optimal development.
During the early breastfeeding months, it is important to remember to nurse the baby before offering solids, because mother’s milk continues to have far more calories and nutrition than solids food. The first six months of weaning during the first year of the bay is to explore taste, texture and color of the solid food variety. This is building a relationship with food safely and enjoyably. This has a life long impact. that the small amounts of healthy solids that can be consumed.
Exclusive breastfeeding for the first six months will mean only breast milk without mixing it with water, no other solid of liquids, herbal preparations or other food except remedies and medications when required. Exclusively supports optimal gut flora and microbiome that behaves as the shield of immunity for the baby from risk of gastrointestinal infection, diarrhea, pneumonia, otitis media and urinary tract infection among other risks. For the mother breastfeeding exclusively reduces risk for developing postpartum depression, Type 2 diabetes, and cancer. Exclusive Breastfeeding is also a method of birth control called Lactational Amenorrhea Method of birth control, or LAM. This method has been reported to be 98-99.5% effective in preventing pregnancy as long as exclusivity is maintained with no mixed feeding methods.
First Tooth
 
Its that time that many mothers dread & decide to stop breastfeeding when they first notice a tooth erupting in their mouth. Usually this is because they might fear that  baby will nip the breast during a feeding session or because the mother fears she will be bitten. It's also the time when during the first phase of teething is experienced by many mothers as one of the most common causes of frequent night waking and frequent feeding for baby. Infact this might be the case fussy nursing behavior due to experience of discomfort in the gums. The only way baby can find comfort sometimes can be suckling at the mother’s breast. During these intermittent phases which run into second year baby’s behaviour at the breast can also resemble staying longer at the breast or even pulling off and crying and wanting to go back to the breast again.
 
This can be extremely overwhelming for the mother and frustrating for the baby. To help baby and mother teething homeopathic pills have been known to be very useful. Also baby can be given a cold washcloth to chew on before feeds to help with gum discomfort. Biodynamic Craniosacral Therapy can be extremely helpful as well to help restore comfort and regulation for both mother and baby.
 
 
 
 
First Weaning
 
Weaning from the breast is usually a slow and gradual process starting during the time of complementary food introduced yet weaning is an interactive process between the mother and her baby. It might help to know baby can be completely be trusted to wean himself as his need for security and comfort slowly get fulfilled over the toddler years and is not a habit that needs to be broken. This is a milestone reached at their own internal pace and like walking, talking and other milestones are different for each child.
 
La Leche League International organisation that supports breastfeeding mothers all across the world recommend gentle weaning methods rather than methods that might harm the trust in the relationship that has been built with nurturing at the breasts. Need for sucking is real for babies which is separate from sucking for nutrition. Sometimes weaning too fast might hamper the milk supply for the mothers or also it might result in babies resort to thumb sucking, sucking on fingers, hair, blankets and pacifiers.
 
According to Norma Jane Bumgarner in her book "Mothering your Nursing Toddler" says "..a baby is learning to trust and depend on other human beings, especially his mother and to suppose that nutrition is primary significance and that attachment is secondary will be a mistake." therefore helping baby to drop her first feed naturally will be gradual weaning process as needs are being met.
 
.
 

​The Covid Lock Down recounts the stay at home joys for all mothers and in a way celebrates staying at home with family. Surely this is an unprecedented time when social time is almost some to a standstill and all activity is focused on the staying safe. There can be feeling of sense of insanity due to not being able to step out despite fulfilment of family time. Most of them may find yourself feeling bored, depressed, bored, worried, or isolated. This is a collective feeling across homes around the world. This can be hard time to cope with. 
Here are some of things a nursing mothers can do with her nursling baby and perhaps also with a toddler or an older children if she has more than one.

• Keeping a Rhythm: Nature’s hidden secret of life is its rhythm and this is the secret of a happy home too and surely the same for happy motherhood. Usually during early days after birth it’s hard to keep a rhythm especially the first 40 days. It’s hard to even get a wink of sleep. However, in this massive transition time too you can still find a way to recognise and keep a small cycles of rhythms — Breastfeeding – Sleep – Change – Breastfeeding. This is the nesting cycle. If baby is older finding a rhythm maybe a bit easier. Aligning with nature is the one of the most profound ways to bring in flow of activities. Early morning breastfeeding is usually the most satisfying for breastfeeding mothers for toddlers. Milk flow is easy during early hours when the hormones dynamics is functioning at its best after a restful night. Spending as much time in the early hours to bond and feed with your baby or toddler can meet much of essential ‘contact’ time baby needs. Soon after this session usually a good chunk of time may become available to get most important chores of the day to be completed cleaning, cooking ect. Meals can be prepared simultaneously and stored away for later use partially prepared for later use. The rest of days can be filled with resting, playing or working from home. All this can run a 45 min rhythm which is a good chunk of time for most things to be completed mindfully and heart fully.
• Keeping active and fit - Exercise or Yoga even for a short 30 min routine can help fight low feel or even depression. One of most wonderful chance is to begin now during the lock down if you had not done it before. Your baby can join you on the routine so easily and help you add fun and some added weight to make your fitness routine bit more challenging.
• Honing your skills – Pick an educational course that hones your existing skills. Breastfeeding mothers with babies’ age between 3 months to 9 months find that they have time to spare to hone a skill or study. Since it’s a lock down period and more hands may be available to care for the baby with your spouse around it could even be a good time to spare a hour for study. There are many online educational programs available of which many are free of cost opened especially for Lock down period.
• Volunteer to support the community – especially breastfeeding families. Volunteering can also be fulfilling. Doing something for a cause is always a great way to cope with hard time and brings in perspective and purpose in a vulnerable time. There are many online breastfeeding support groups that one can volunteer on like Le Leche League Pan-India Group or Breastfeeding Support Group for Indian Mothers. (BSIM). This can be done while you are nursing. Mother to mother support is most valuable support breastfeeding women has have as it is seen across the world for centuries.
• Working from home – If you are a working mother than finding a routine even during these times may become even more essential. Keeping a certain discipline around, house work and breastfeeding and pumping (in case you had been doing that earlier can help you continue keeping that routine at home too and gain a large chunk of time to complete your business work). It may be lot easier sometimes to just nurse your baby if you had been a pumping mom and this might even be a great way to build up a good supply since nursing baby can always way better than breast pump can.
• Redefine your goals – In a way this is also a time that is making us rethink and redefine our lives in a holistic way to go back to primal instincts of what brings you most joy. Many mothers are beginning to feel that nothing ever can be traded for getting to spend joyful time watching children walk, talk, laugh and play. This is priceless to find reverence in the living in the moment. Breastfeeding experience is closest to the living in the moment.

 ​

 Panic & anxiety has been on the high during this unusual situation worldwide with a pandemic of Corona Virus (Covid-19) looming on us. Particularly young parents with new-borns and infants feel vulnerable about information given to them on how to manage illness while breastfeeding or caring for a newborn. Here is a guide for young families on this current situation of global crisis.

What is Corona Virus?
According to the World Health organisation Coronaviruses are a large family of viruses which may cause illness in animals or humans.  In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold with mild symptoms to more severe respiratory diseases that may need intensive care.

How contagious is it & how does it transmit?
It is considered to be highly contagious and it is transmit via droplets of sneeze and cough of a person who is already infected. Therefore frequent washing of hands has been highly recommended.

 I am breastfeeding my baby, should I worry about Covid-19?
Mother’s milk provides immune protection against many different illnesses such as respiratory illnesses like SARS-CoV or Middle Eastern Respiratory Syndrome (MERS-CoV). Both these viruses were a form of Corona Viruses.

How does my baby get immune protection from me & my milk?
Mother’s milk is produced in the mammary glands which is a part of the secretory immune system. Breast milk contain antibodies which can highly targeted against infectious disease viruses & bacteria found in mother’s surroundings. The immunoglobulin which are immune boosters are found abundant in breast milk. More compelling scientific evidence comes from studies of the effects of Human Milk oligosaccharides (HMOs) against all kinds of infectious diseases. So far scientists have found over 200+ human milk oligosaccharides.
What is amazing is the pathway these antibodies take in the mother’s body to reach her baby. The pathway is unique and irreplaceable any other method of feeding. This pathway maybe likely damned during expressed breastmilk in a bottle. This pathway is called Entero-Mammary Pathway. The Mother's Gut contains millions of neurons which is more than 70% of the immune system. The pathogens that enter the mother’s body triggers a process of making of the antibodies in the mother’s gut. These antibodies in the mother’s gut travel to the mammary gland and enter the milk.
Babies receive antibodies specific to the mother’s intestinal pathogens.

I am a breastfeeding mother & have tested positive for Covid-19 Infection, should I continue breastfeeding my baby?
The limited studies have shown that the corona viruses are not found or detected in breast milk. COVID-19 infection is seen to produce mild symptoms, especially for babies & children. Therefore you should be able to safely continue breastfeeding your baby with basic precaution to ensure you keep your hands clean before handling your baby or during diaper changes.
If you are too sick to feed your baby at the breast which sometimes can occurs in small percentage of infected population, you can continue to express your milk and offer it to your baby. Ensure to wash your hands well and sterilise your pumping equipment before expressing. It is best to be in touch with your Lactation Consultant for help and support during your illness. 

Should I stop breastfeeding if I am on medications?
Many medication do pass into breast milk however the amount is known to be insignificant often. Most antiviral drugs are known to be safe for baby. However it is best to refer to Drugs and Lactation Database LACTMED and similar services for safety of the drugs used.  Drugs and Lactation Databases includes information on the levels of such substances in breast milk and infant blood, and the possible adverse effects in the nursing infant. Alternatives to those drugs are provided, where appropriate. All data come from scientific literature and are fully referenced. A peer review panel reviews the data for scientific validity and currency.
​
What If I need hospitalisation?
In you require hospitalisation, depending on your condition, you may be allowed to room-in with your baby with all necessary precautions while you are in isolation. Using a facemask and keeping hands washing hygiene may be critical during caring for your baby during treatment. Sometime they may need to add a separation screen or another room between you and your baby if your condition requires isolation. In such a situation you may need to express milk and allow a non-infected person to feed the baby.