Setting Mom and Baby Up for Breastfeeding Success in the Hospital: More Than Just the Latch

Getting moms and babies off to a good start with breastfeeding in the first few days following birth is crucial to future success.   We know that early effective feeding helps to establish a full milk supply and leads to longer breastfeeding duration.  But what is the best way to support this important time?  Of course we have the well-established “Ten Steps to Successful Breastfeeding,” for guidance.   These steps, developed by the World Health Organization (WHO), outline the best evidence-based strategies for those who are providing care for breastfeeding mothers in the maternity setting . Aside from these steps, or the so-called, “nuts and bolts,” of support, there are other equally important ways to encourage and enhance a new mother’s first experiences with her newborn and breastfeeding.   

Let’s start by taking a look at some of the hormones related to breastfeeding.

Oxytocin:  This hormone is often referred to as the “love hormone.”   It’s released during childbirth and breastfeeding and is a key factor in human bonding.   Oxytocin is also stimulated with light touch, stroking and warm temperature, as well as hugging, kissing and sexual intimacy.    Even sharing a meal with someone can release this pleasure hormone!  Another big booster of oxytocin release is skin-to-skin contact.  In fact, the oxytocin pulses released by skin-to-skin contact are even more long-lasting than those observed during labor and breastfeeding.

 Prolactin:   This hormone is also called the “mothering hormone.”  Prolactin is elevated in breastfeeding, and is responsible for stimulating milk production.  Prolactin levels spike following periods of suckling by baby.  Prolactin also has the unique effect of increasing protective behaviors in mothers.

 Endorphins:  These hormones are often called the “happy hormones.”   They can have a pain-relieving effect and promote an overall feeling of calm.   And when mom’s endorphins are high, they actually pass right to baby via breast milk!   Some well know endorphin releasing activities include meditation, laughter, listening to music and getting a massage.

Taking all of this information into consideration, think about what kinds of things might be supportive of early mother-infant interactions and breastfeeding, and what things might interfere with this process.  What things can boost these hormones, and what types of things inhibit them.

The non-supportive environments listed above can inhibit a mother’s natural instincts towards her baby and breastfeeding

We also need to remember that not only is the mother sensitive to her environment, but so is her baby.   He’s just emerged from the safety and relatively dark and quiet womb, out into the world of bright lights, noises, cold air – and on top of all that, he has to transition to breathing and eating on his own!   Imagine yourself trying to learn something completely new.   A dance, a language, a new job.   It’s a lot to take in, and a relaxed environment is a lot more conducive to learning and releasing natural instincts than a stressful one.

According to Suzanne Colson, a research midwife and nurse, oxytocin, is a “shy hormone.”  Oxytocin release is inhibited in the environment of “loud, nervous, worried people who ask many question or who make negative comments.”  It also “runs away from people who observe, or peer, prod, or touch.”   Suzanne also makes a strong statement about those supporting breastfeeding in the early days.   She says their role is “to protect a mother’s privacy, creating an environment conducive to the secretion of oxytocin and prolactin.”[1]  Wow.   That’s a big paradigm shift for most of us who work at the bedside.    I know for me personally, I have a tendency to jump into “teaching,” mode.   Thinking about a hormone boosting environment wasn’t always a part of my thought process.

But I have witnessed the transformative nature of supportive environments.   Take this situation for example: I have been called to help a baby latch in the labor room about an hour after birth.   I’m met by a harried, busy  nurse who says “I just can’t get the baby on.”    When I go into the room, the bright delivery room lights are still on high.   There are people bustling around the room, in and out.  Baby is protesting loudly, and mom dad are anxious.  I can start by making some simple adjustments – dim the lights, close the door, request some privacy.   Next, allow the baby to be skin-to-skin with mom without trying to “get the baby to latch.”  Allow the baby to settle and begin to cue for feeding on his own.  And “Voila!”  baby settles, latches and breastfeeds.  Mom and dad relax and we have a whole new picture.   Now, does this happen every time?  Of course not.  Each and every situation is different.  But taking a look at the environment is an important piece of supporting early breastfeeding.

I suggest that you consider adding “creating a hormone-supportive environment,” into your breastfeeding support “tool bag,” and see how it works out.  Before you jump in and “help,” consider the environment around you.    Try dimming the lights.   Suggest that mom relax with some of her favorite music.  Help her to get comfortable.  Be sure she is not in pain and that she feels warm and cozy.  Encourage skin-to-skin contact.  If mom’s partner is an active participant, include him or her in the process-maybe a nice back or foot rub by partner.   Overall mom should feel safe and secure.   I think you’ll be pleasantly surprised at the way these environmental adjustments can help.  And chances are that mom will remember you not for what you taught her, but how you made her feel comfortable, relaxed and confident in her own ability to feed her baby. 

Mary Foley RN BSN IBCLC 

[1] COLSON, S. (2019). Biological nurturing: Instinctual breastfeeding. PRAECLARUS Press.