[Editor's Note: This is our fourth installment of guest posts from Lamaze International's 2009 Annual Conference speakers. Dr. Kendall-Tackett will present the Opening Plenary Address at this year's conference. You can listen to podcast interviews will all of our plenary speakers online. You can also read our other conference previews by clicking on the Lamaze 2009 Annual Conference tag. We hope to see you October 1-4 in Orlando at the Lamaze International 2009 Annual Conference. - AMR]

Kathleen Kendall-Tackett, Ph.D., IBCLC

In modern Western cultures, mothers have more information about breastfeeding than any time in human history. Unfortunately, most of this information is left-brained, which works well for some tasks, but can be a problem for breastfeeding new mothers. That is because breastfeeding is a right-brained activity. What do we mean by that? Think of left-brained instructions as head knowledge. Right-brained learning yields heart or body knowledge. To illustrate the difference, think about riding a bike. Did you learn by reading about it? Talking a class? Talking to other people about it? Or did you learn by just getting on a bike and doing it?

The Right-Brained Relationship of Breastfeeding

Mothers and babies have physiological responses that draw them to each other, that encourage them to look at each other, touch each other, and interact. Much of this behavior is guided by the right side of the brain. This is the side that has to do with affect or emotion.

A problem with the heavily left-brained, instructionally oriented way that many mothers learn to breastfeed is that it doesn't allow mother and baby to take advantage of their natural responses. So much breastfeeding education focuses on all the things mothers must to do get the baby to breastfeed, which ignores the baby's role. That type of instruction can be helpful to solve a particular problem, but it can be a definite drawback when one technique or strategy is applied to all mothers. It also discourages mothers and babies from using their hardwiring. Worse still, this kind of education can encourage them to tune out their natural responses or to violate their instincts. It can be upsetting for all who are involved, sometimes creating a crisis where none existed before. Another problem with highly instructionalized left-brained approaches is that they can leave some mothers feeling incompetent because it feels as if there are ten thousand things they need to remember.

A different way to think about this is to consider how mothers throughout human history managed to breastfeed without all of the information we have now. When breastfeeding was the norm, girls learned about breastfeeding as they were growing up by seeing women actually doing it. Dr. Peter Hartmann, a well-known breastfeeding researcher, makes this point well. He asked a young Australian Aboriginal mothers, 'When did you learn about breastfeeding?' She answered, 'I have always known how to breastfeed.'

So how can mothers use a right-brained approach to breastfeed their babies? First, encourage mothers to take some deep breaths and let go of those worries about doing things 'wrong.' Instead of thinking of breastfeeding as a skill mothers need to master, or a measure of their worth as mothers, encourage mothers to think about breastfeeding as primarily a relationship. As mothers spend time with their babies, they'll start to feel more adept at reading their cues. As they hold their babies, the babies will start seeking their breasts. Breastfeeding will flow naturally out of their affectionate relationship. Based on her extensive clinical experience with mothers and babies, pediatrician and board-certified lactation consultant Dr. Christina Smillie has developed some strategies that can help you help mothers. Here are some specific things you can do.

Start with a calm, alert baby. Sometimes women wait to breastfeed until their babies are screaming. Think about yourself. Do you learn best when you are upset? Probably not. The other reason to start with a calm baby has to do with physics. When a baby is screaming, her tongue is on the roof of her mouth. Mothers will never get their breasts in their mouths when their tongues are like that.

Watch for early feeding cues. These cues include turning her head when someone touches her cheek and hand-to-mouth. Help mothers take note of when their babies starts smacking their lips or putting their hands to their mouths. This is an ideal time to try breastfeeding.

Encourage mothers to use their bodies to calm their babies. One way to calm a crying baby is by having mothers place their babies skin to skin vertically between the mothers' breasts. A mother's chest is a very calming place for her baby. Encourage mothers to try talking and making eye contact. All of these activities can calm the baby down, allowing the baby to seek the mother's breast on her own.

Follow the baby's lead. When a calm, alert baby is held vertically between her mother's breasts, often she will begin showing instinctive breast-seeking behaviors, bobbing her head and moving it from side to side. Once babies start these behaviors, mothers can help in their efforts. Mothers should following their babies' lead, supporting the babies' head and shoulders, and encouraging their babies with their voice.

Have mothers play while they learn to breastfeed. Play is something that is largely absent from the mothers we see. It all seems so serious and they are terrified of doing something wrong. If mothers are feeling frustrated, encourage mothers to focus on their relationship with their babies and consider breastfeeding as a part of the larger whole. Breastfeeding will flow naturally out of their affectionate relationship.

In summary, if babies are healthy, they are wired to know how to breastfeed. It all doesn't depend on mothers getting everything 'right.' Encourage mothers to relax and just focus on getting to know their babies. The rest will follow.

Dr. Kendall-Tackett, Ph.D., IBCLC, is a health psychologist, International Board Certified Lactation Consultant and La Leche League Leader. She specializes in synthesizing current research on breastfeeding and related fields, facilitating the provision of evidence-based care. Dr. Kendall-Tackett has authored more than 180 articles or chapters and is the author or editor of 17 books on maternal depression, family violence and breastfeeding. This post was co-authored by Nancy Mohrbacher, IBCLC.

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