How Birthing from Within Shapes My Lactation Practice
by Megan Malone-Franklin
I was lucky to come across Birthing from Within in the early years of my practice as a birth worker. As I learned more about feeding babies and became a lactation counselor, I started noticing ideas I'd learned from my BFW training showing up in my lactation practice. Now that I see dozens of families each year specifically for lactation support, I want to share the top 10 ways BFW has shaped my lactation work:
One: Validation first.
It's easy for medical professionals, birth professionals, and well-meaning family and friends to offer advice or information first upon hearing that someone is having some difficulty navigating their lactation journey. When I enter a family's home and start hearing their story, I know to begin by validating their experience, which often results in a sigh of relief (and sometimes even tears). Creating room for someone to feel seen and heard before we even begin addressing their challenges is a beautiful way of holding space for families in these tender early weeks with a newborn.
Two: Approach each family with a "beginner's mind."
In each visit, I try to leave all my assumptions at the door and remember that each family is unique. Rather than jumping to conclusions about what a particular family probably needs, I work to learn more about their goals and challenges. This approach often leads to deeper conversations and more meaningful, effective ways to address current issues. Each baby is their own self, a brand new human being. They have their own needs, preferences, and tendencies. I love learning about each baby alongside their parents, and exploring ways of helping them eat. It’s always interesting to see what will work in a new breastfeeding/chestfeeding relationship! Although I have lots of tricks up my sleeve, I avoid thinking of any of those tricks as “tried and true.” What worked for the last family might not work for the next.
Three: Understand that lactation is a journey.
Just as in birth work, it's important to understand that twists and turns are a normal part of learning to feed a baby. When I approach lactation this way, it makes it much easier to validate this feeling in my clients, and to understand why "righting the ship" isn't an overnight process. Sometimes families receive medical lactation support that makes them feel as if any little thing that isn’t going perfectly is a big problem that could threaten their ability to breastfeed/chestfeed their babies. Keeping in mind that this process takes time to learn and that it’s normal to experience ups and downs helps me guide my clients towards finding solutions for the little things that aren’t quite right yet instead of giving up because we can’t make it perfect all at once.
Four: Teach coping strategies for tough moments.
Even when everything is going perfectly on paper, the round-the-clock demands of feeding a new baby can feel incredibly intense. It is not always cozy. It is not always sweet. It is not always comfortable. It does not always feel manageable. Birthing from Within’s emphasis on teaching coping practices in preparation for labor has been so useful in my lactation work. When things are feeling rough, I love offering some ways to help breastfeeding parents get through (ideally with their self-compassion intact). Sometimes this is as simple as helping someone remember to breathe or roll their shoulders back while they’re nursing. Sometimes it means introducing bottles a bit earlier than planned so the nursing parent feels less pressure within the daily routine of feeding their newborn. And sometimes, helping parents reframe their experience and remember just how huge a transition new parenthood is - mentally, spiritually, and physically - is what’s needed when things are feeling difficult.
Five: Soften expectations.
Birthing from Within has shown me that expectations play a crucial role in people's satisfaction with their birth and postpartum experiences. This concept applies equally to lactation, and has become a central component of my support. I guide parents towards softening their expectations of themselves, their babies, their support network, and what the overall process can look like when learning to feed a little one. This often helps families to become more clear about their goals, what they're willing to do to reach those goals, and what resources may be needed along the way.For example, many of my clients have read or heard that when nursing is going well, it shouldn’t be painful. While that’s true in general, there are so many factors at play, some of which are out of our control. Sometimes, as babies are learning how to latch deeply with every feeding, they have a not-so-great latch once or twice (or several times) that cause lingering pain for a few days. Sometimes it’s hard to find that “just right” position that allows for a pain-free latch. I encourage my clients to remember that pain is a signal that more lactation support is needed. It’s important to me to help parents to understand that some discomfort or pain is a normal part of the journey as they and their babies learn this dance together. By softening their expectations in this way, parents can be less judgemental of themselves and their babies during this learning process.
Six: Understand that, as in birth, sometimes "interventions" are exactly what's needed in the moment.
Often I hear other birth professionals vilify tools like nipple shields, formula, or pacifiers. I help clients understand the benefits and disadvantages of introducing these kinds of tools, but I am careful to use a more neutral tone, understanding that sometimes using one of these resources can be the difference between someone reaching their goals or not, or even whether they have a positive experience feeding their baby. When I perceive that a certain family may benefit from one of these extra tools, usually we have some long conversations about what the tool is and how it could help in their specific situation. Often things are much more grey than black and white, so we spend time together discussing different paths that could be taken to address the issue. By having the opportunity for this kind of dialogue with a compassionate, knowledgeable specialist, parents usually feel like they can better understand what’s going on and what their options are. Then they are able to make a decision that truly feels right for them, without judging themselves or their babies.
Seven: Access parents' own inner creativity.
I have observed that when I focus on helping parents understand the mechanics of lactation and feeding, they often begin to come up with their own creative solutions to challenges they're facing. I am still there to offer guidance and information, but encouraging parents to participate in this way once they understand the principles at play is so much more rewarding, both for my clients and for me. For instance, instead of telling my clients how many minutes they should be nursing on one side or the other, I love explaining the kinds of signals babies give when they’ve had enough milk from one side and are ready to switch or stop nursing. Then parents are usually much more confident in making these decisions, often starting to notice the little quirks of their own baby’s behavior that tell them whether they’re satisfied or still want more to eat. More confidence plus connection to their baby? I call that a win win!
Eight: Focus on what this moment needs.
By becoming more aware of the moment at hand, I've developed much more flexibility in my practice. I work with my clients to develop a plan to move forward, but I always encourage them to let me know if they feel that something isn't working. Rather than blindly sticking to any given plan, it has become second-nature to help my clients make adjustments in response to what the moment calls for.
Nine: Understand the complexity of the newborn time.
The early days with a newborn are filled with so much change. Keeping in mind the changing roles, a changing feeling of "who you are" (for everyone else in the family's inner circle), feelings of joy, overwhelm, exhaustion, great love, confusion, and so much else... it's important to remember how feeding a new human fits in with the rest of what's going on in a family's life at this time. As a lactation professional, I try to always keep this in mind. Even though feeding a baby can take so much time, energy, and attention, it is not the only thing going on during these early weeks and months. For someone who is exclusively pumping and trying to increase their milk supply, the standard advice is to pump every 2-3 hours and wake up to pump at least once overnight. In reality, that just might not be doable for some people. For those parents, I make sure to have an honest conversation with them about how many pumping sessions would be realistic for them, how that amount of pumping may or may not help them to reach their goals, and how it would affect their day to day experience. Sometimes approaching things from a whole-person, whole-family perspective can help a parent figure out what matters to them most and make the decision that feels right for them.
Ten: Help clients feel like parents, not patients.
New parents are so often looked down upon or treated with condescension by medical care providers. Even in the midst of guiding parents through a specific challenge or answering questions, I always strive to communicate to my clients (even in subtle ways) that they are in charge and I am there simply to guide. By having conversations and asking my clients lots of questions rather than getting a bare bones outline of the situation and then giving directives, I remind my clients that their experiences and perspectives are extremely valuable. I also have explicit conversations with them about the difference between patients and parents in this context to help them understand that they will take an active role in the time we spend together. They are not patients, to be given instructions and told what to do by experts who know better. They are parents, uniquely prepared to make decisions and care for their own baby with intention and love. That doesn't mean there may not be moments of doubt or a need for extra support. But by placing parents and their babies at the center of my practice, I am able to be there for families in tender moments, offering gentle support as they move through life together.As a bonus, parents can take this perspective to heart and begin approaching other support (like pediatrician visits) as parents instead of patients too, helping them receive better quality care that is much more personalized to their needs. I’ve even heard from a few parents that this was their biggest takeaway from my lactation support! Handing parents the reins like this during lactation consults is one of my favorite parts of this work.
By approaching my lactation practice with humility and curiosity, I find that the conversations I have with my clients are much more productive and juicy than they would have been otherwise.
Whether by truly taking the time to understand parents’ concerns so I can offer really specific suggestions, or by helping them to get a realistic picture of the possible paths forward, or by making space for my clients to come up with their own creative solutions, Birthing from Within has made me a much more effective lactation professional.