So I Nursed Him Every 45 Minutes
By Elizabeth N. Baldwin, Esq.
by Kenneth A. Friedman, Esq.
I nursed my first child every 45 minutes--big deal. Boy, was it! I never expected a child of mine to be so demanding. He had to nurse every 45 minutes or else ... else he'd scream till the end of time. Or so I thought; I never found out. After all, if I let him nurse every 45 minutes, he was in seventh heaven, so who was I to complain?
Hmmm ... complain. What about all those baby books bedecked with lovely charts and graphs of when babies sleep, eat, and have alert periods? Reading them as a pregnant lawyer, I was sure I could fit my work into the designated "sleep" intervals. The books never mentioned a baby who wanted to nurse every 45 minutes, then sleep blissfully in mother's arms.
Was this my fault? Wasn't the fact that my son slept through the night a sign that I was doing something right? Ha! He only slept through the night until I wrote it down in my journal. Then he began walking every two hours! Now, I'm not a superstitious person, yet I must confess that I promptly crossed out that entry and wrote that he did not sleep through the night. It didn't work; he still woke up every two hours to nurse.
Oh, help, I thought, am I causing him to wake up so often? Tempting him with the equivalent of hot chocolate chip cookies in the middle of the night? Should I be depriving him to encourage some compliance with proper schedules? Letting him suffer so he will fall into the norm described in all those books?
Luckily, for my son's sake, I trusted those darn instincts I didn't think I had, and I let him just nurse and nap in my arms whenever he wanted to by day, and nurse and sleep beside me whenever he wanted to at night. Those instincts, however, were not easy to distinguish from messages I had carried since childhood. These were ingrained so deeply that they felt like instincts, yet they were really more like old tapes running over and over, criticizing, judging, and blaming at every provocation. My instincts told me to keep my thoughts to myself. And I learned to do just that, and to let my instincts guide me.
My instincts told me that my precious little baby needed to nurse whenever he wanted to. After all, he had spent nine months inside me, and I was all he knew. Whenever I looked at the peaceful, happy expression on his face as he nursed, I could imagine him feeling as though he were back in the womb--hearing my heart beating, my stomach gurgling, the sound of my breathing, and feeling attached to me! Yes, my instincts told me that if he was happy in my arms, then that is where he needed to be.
After I figured out what my instincts were, I came upon a greater challenge: learning to trust them. How hard this was amid the advice I was getting from family and friends, even from hospital staff and doctors. "That baby couldn't be hungry again--you must not have enough milk!" I was told, and "Maybe he wouldn't be so needy if you'd go longer between feedings." Nearly all their counsel went against my instincts, and suggested that I was doing something wrong.
Why, I wondered, does society push mothers to ignore their instincts?(1) Why, when developmental researchers emphasize how important it is to be responsive to our babies,(2) are mothers still encouraged to disregard the instincts that help them respond? Is it because we as human beings are programmed to repeat what was done to us?(3) Were the "reasons" I was given by family, friends, and professionals mere justifications for the lack of responsive nurturing they received?
Well-meaning folks told me that I was harming my baby by nursing him whenever he wanted, especially since he nursed so often. As a matter of fact, my baby's doctor said that frequent nursing was causing him to be colicky, and that if I would only wait three or four hours and give water between feedings, he would calm down and be a happier baby.
I, meantime, was coming upon discoveries of my own. I learned that breastmilk is digested in two hours, not three or four like formula.(4) I learned that many babies want to nurse more frequently than every two hours,(5) and that babies who nurse a lot tend to get plenty of milk because their mothers' milk supplies have been boosted by the frequent nursing.(6) Research now shows that restricting the amount of time at the breast and extending the time between feedings can reduce not only a mother's milk supply, but also the fat content of her milk(7)--resulting in a hungry, crying baby.(8)
Sadly, I also learned that babies who are nursed at four-hour intervals may fail to thrive. One infant, who had been breastfed for 15 minutes on each breast only six or seven times a day, cut back on her nursing and died of starvation a few days later. Her parents were convicted of manslaughter. Fortunately, the conviction was reversed because these parents had no idea they were doing anything wrong.(9) They were simply following the recommendations of a culture that knows little about breastfed babies.
My baby, I concluded, knows what he is up to. He knows what he needs, when he needs it, and how to get it. Any arbitrary decision on my part--even when to switch sides--seemed counterproductive. How could I possibly know what his body needed? Indeed, as I later learned, breastfed babies regulate themselves; they take what they need, not just at each feeding, but from each breast.(10) Moreover, many breastfeeding problems--including those attributed to "too much milk" or "not enough milk"--are resolved with more frequent nursing.(11) So I continued to follow my baby's cues. And I soon found out that his "colic" was directly related to my hidden food allergies and overconsumption of dairy products.(12)
A well-meaning friend suggested that I was depriving my baby of a good night's sleep, and that I "owe it to him" to teach him to sleep alone through the night. Now, by my calculations, sleeping beside him was depriving him of far less sleep than he would have lost had he been left to cry his eyes out only to realize that I was not there for him. Little did I know that our nighttime rituals were decreasing his susceptibility to SIDS (Sudden Infant Death Syndrome),(13) and were exactly what his developing system expected.(14) What I did know was that mothers have slept with their babies since time began. How could something that felt so natural to a mother be bad for her child?
Relatives said that I was teaching my baby to cry. "If you go to them every time they cry," said one, "they'll learn that is the only way to get you to come, and you'll be manipulated." Right off, this made very little sense to me. If in fact my baby is crying to get me to come, I reasoned, then isn't that what crying is for? Besides, my son has already learned that he does not have to cry to evoke a response; he only has to go, "Eh, eh," and I will be there in a flash, or awake in an instant. While I knew that my baby had learned to communicate nonverbally through cues and, in times of upset, through tears, I did not yet know that as a toddler he would be asking for things rather than yelling for them.
The accusations continued. My father-in-law banned us from his house for three months because I had been jumping up too often during dinner to take care of my little one. He said that my son was learning zero about delayed gratification, becoming too dependent on me, and likely to grow up a "mama's boy" tied to my apron strings. Yet, my instincts told me that he was too young to learn delayed gratification, and that if I met his dependency needs now, he would blossom into independence all on his own.
Relieved to find expert opinions that validated my instincts,(15) I concluded that my son was dependent on me because he was supposed to be. Only a caring, predictable environment could help him experience the world as a warm, loving place. The notion of pushing children into independence, I found, stemmed from an age-old belief that babies are born wicked and a parent's job is to break their will and turn them into well-behaved children. I, on the other hand, believe that babies are born precious and learn to behave by the ways in which they are treated.
Several critics cast doubt on my own well-being. Some said that remaining constantly available to my son would make me nervous and anxious, and would stop my milk from letting down. Others suggested that if I didn't allow someone else to take care of my baby from time to time, I would get stressed out or depressed, which would "mess up" my hormones. Yet, for me, depression would result from not responding the way my "hormones" were telling me to; it seemed as though nature was screaming at me to listen to my baby. I felt much less stress as soon as I realized that it was OK for him to be needy, and OK for me to be responsive. If anything was making me anxious and nervous, it was their words. Being responsive felt right--more right than anything I had ever done in my life.
And yes, I was even accused of being a martyr, of suffering for my child. This one amused me as I watched nonnursing friends sterilizing bottles, preparing formula, carting around small kitchens in their diaper bags, and treating constipation, diarrhea, and other common side effects of formula. On the flip side, I was accused of taking the easy way out, as if something so effortless for a mother could not be good for her child! The insinuation was that because my son fell asleep at the breast in 30 seconds, I was breastfeeding because I was lazy.
Many people suggested that I was depriving my husband of an involved role in childrearing. Admittedly, I was indispensable to our son, and hardly able to leave for the bathroom if he was hungry or upset. However, when all was going well, he loved being with Daddy. He enjoyed lying on Daddy's chest, exploring the cabinets while perched in his arms, going for backpack walks and drives past the transmission towers, all the while assured that Daddy would bring him back in a flash if he needed me. As he grew, his relationship with Daddy grew. Shrieks of delight that greeted his return from work evolved into requests for so many things, including his presence at bedtime. (Daddy told better space stories than Mommy!) Surely, one reason they became so close was because their relationship was rooted in a secure mother-infant base.
I did not know all this at the time, of course. Nursing every 45 minutes leaves a mother with little opportunity to evaluate her methods, much less defend herself against criticism. That came later.
In due course, I realized that if I did not respond immediately to my son's cries for my attention, he would not cry his little head off forever. No, he would eventually give up, convinced that communication is not effective. He would sense that he has no rights, and no idea of what is good for him. He would conclude that he should not be hungry when his body tells him he is, and that he is wrong to feel what he feels.
I also realized that our society has little understanding of newborns, and does not sanction compassion for their needs or feelings. Demand nursing, as I saw it, was no different from caring for a family member who has been rendered powerless. Would we refuse an incapacitated father a meal because it was "not time"? Or leave a paralyzed spouse alone in a room to "cry it out"--checking in every 10 minutes to say, "It's Ok"--without trying to find out what is wrong and doing something about it? If he or she only wanted to be held, would we refuse, for fear of spoiling someone we love? How can anyone claim that legal or religious tenets require us to deny babies sustenance and comfort "in their best interests"?
Even the medical profession has been insensitive to the suffering of babies. Until recently, many doctors thought it unnecessary to give infants pain medication for surgery; only paralyzing agents were given, to keep them from moving. The belief was that babies do not feel pain.(16)
Surely someday, our society will recognize that babies are people--with rights, feelings, and most importantly, needs. At that point, communities will advocate for these needs, with the knowledge that nursing-on-demand mothers are not spoiling their little ones, creating bad habits, letting their babies dictate their every move, or getting wrapped around little fingers, but rather doing exactly what nature intended. Mothers are designed to be available to their babies--to help them make the transition into this big, wide world. To teach them to trust, and love, and feel good about being alive.
Until then, I decided, a mother has one of two paths to travel. She can adhere to the advice of others, and give her child this message: "Suffer, kid, I've got more important things to do, and I don't care that you can't satisfy your hunger (thirst, desire for contact)--I've got a life, you know." Or she can listen to her instincts, and convey an altogether different message: "I am here to let you know that your needs can be safely met."
As for me, I continued to listen to my instincts. I let the dishes, work, and social times slide, knowing that they would always be there whereas my baby would not. I let the nights go by with varying amounts of sleep, and the days roll on with little sense of accomplishment. And looking back, I want to shout with joy that I did. My precious infant who nursed every 45 minutes grew and grew--into an independent, happy, intelligent, and confident nine year old with compassion in his heart and affection in his acts.
(1) Cultural offshoots of the factory model of breastfeeding may be one of the reasons the medical profession has encouraged scheduled feedings. In the first decades of this century, people new to factory work had difficulty obeying the strict schedules required of them; the literature emphasized that teaching infants a schedule would help them become responsible adults, and ultimately good factory workers. Other factors contributing to scheduled feedings may be the extension of professional advice into family matters, the changeover in birth and breastfeeding management from lay midwives to physicians, a general mistrust of women's body signals (such as the let-down reflex as an indicator for nursing), and a mistrust of infants' signals. See A. V. Millard, "The Place of the Clock in Pediatric Advice: Rationales, Cultural Themes, and impediments to Breastfeeding," Soc Sci Med 31, no. 2 (1990): 211-221, which suggests that breastfeeding problems in the United States are culture-specific, and are a result of pediatric breastfeeding regimens.
(2) Mothers of securely attached children--who do better later in life--are more responsive to the feeding signals and crying of their infants, and more likely to return their babies' smiles. M. D. S. Ainsworth and S. M. Bell, "Attachment, Exploration, and Separation: Illustrated by the Behavior of One-Year Olds in a Strange Situation," Child Development 41 (1970): 49-67.
(3) See Alice Miller, Thou Shalt Not Be Aware (New York: Penguin Books, 1986).
(4) Breastmilk is digested in 60 percent of the time required for infant formula. See B. Cavell, "Gastric Emptying in Infants Fed Human Milk or Infant Formula," Acta Paedia Scand 70 (1981): 639.
(5) See William Sears, The Fussy Baby (Franklin Park, IL: LLLI, 1985).
(6) See La Leche League International, The Womanly Art of Breastfeeding (Franklin Park, IL: LLLI, 1991); and S. E. J. Daly et al., "The Short-Term Synthesis and Infant-Regulated Removal of Milk in Lactating Women," Exp Physiol 78 (1993): 209-220.
(7) D. A. Jackson et al., "Circadian Variation in Fat Concentration of Breast-Milk in a Rural Northern Thai Population," Br J Nutr 59 (1988): 349-363.
(8) See Note 1. Millard points out that 20th-century breastfeeding schedules have created hunger as a result of long intervals between feedings. This hunger has been erroneously attributed to an insufficient milk supply--the predominant reason given by women for switching from breast- to bottle-feeding.
(9) Commonwealth v. Carol A. Michaud, Normand R. Michaud, 389 Mass. 491, 451 NE 2nd 396 (Mass., 1983).
(10) See Note 6, Daly.
(11) See Lactation Consultant Department of LLLI, The Lactation Consultant Series, pub. no.288:1-17.
(12) When mothers are mildly allergic to cow's milk products (even without overt symptoms), overconsumption of dairy products often causes a reaction in her breastfed baby. For an excellent discussion of food intolerances in breastfed babies, see Maureen Minchin, Food for Thought (North Sydney, NSW, Australia: Alma Publications, 1986).
(13) James McKenna, "An Anthropological Perspective on the Sudden Infant Death Syndrome (SIDS): The Role of Parental Breathing Cues and Speech Breathing Adaptations," Med Anthropol 10 (1986): 1; and J. McKenna et al., "Sleep and Arousal Patterns among Co-Sleeping Mother-Infant Pairs: Implications for SIDS," Am J Phys Anthropol 83 (1991): 331-347.
(14) James McKenna, "Rethinking Healthy Infant Sleep," Breastfeeding Abstracts 12, no. 3 (Feb 1993): 27-28.
(15) See F. L. Ilg et al., Child Behavior (New York: Harper & Row, 1981); and other books from the Gesell Institute of Human Development.
(16) Jill R. Lawson, "The Politics of Newborn Pain," Mothering, no. 57 (Fall 1990): 40-47.
Elizabeth N. Baldwin was an attorney and family mediator in private practice with her husband, Kenneth A. Friedman, in Miami, Florida. She died in March 2003 after an extended illness. Her family law practice primarily focused on protecting young, securely attached and breastfed babies in divorce cases. Elizabeth was also a La Leche League Leader, and a member of LLLI's Professional Advisory Board, Legal Advisory Council. She published numerous articles on breastfeeding and the law, and often spoke at conferences. She assisted hundreds of parents involved in breastfeeding legal cases, and provided information and help to parents, attorneys and other professionals dealing with these issues.
Copyright ©2000, all rights reserved. This article may be printed out for personal use but may not be reproduced in any other manner nor for any other purpose without permission from the author.
By Kenneth A. Friedman, JD
I wanted only the best for my child. Yet then, as now, the issue seemed to be: who will control?
It didn't make any difference to me whether or every 45 days. It wasn't I who had to be available constantly, day and night. In the morning before leaving for work, I would set my wife and child up for "nursing and napping" in the rocking chair. I'd put the phone, books, notebooks, a glass of juice, clean diapers, and other necessities within reach. At night, I was useless, and soon learned not even to wake up.
The pressure to control my child, however, was dramatic. Friends, acquaintances, relatives, and even people I didn't know required that our baby be controlled. The implication was that if we did not regulate his demands on our time and energy, he might grow up to be spoiled rotten or become a second Hitler.
For fathers, the control issue is particularly difficult. Most of us were trained to exercise self-restraint at every opportunity. As boys and young men, we were told to be tough because it is a cruel world out there. Similarly, as fathers, we feel charged with the duty of making sure life is not too easy for our offspring so that they can learn self-control, responsibility, and determination. Combined, these factors can easily prevail over a father's desire to support demand nursing, a practice that allows an infant to control the process. After all, we would never let an infant take charge of our armies and weapons of war, our diplomatic endeavors, or anything else in life.
Not surprisingly, as my wife nursed our firstborn on demand, I experienced this pressure to conform our childrearing methods to some prescribed standard. The hardest part was that I found little support for our efforts to do what we thought was best for our child. Even my most "liberal" friends felt compelled to direct their relationships with their children, rather than let their children guide the way.
While my wife nursed our second child on demand, I continued to struggle against the impulse to control my offspring, not always successfully. Many times I longed for someone to tell me that we were doing the right thing, that my kids would not grow up to be "sissies."
As our children moved out of diapers and away from the breast, I slowly realized that the control issue extends beyond infancy and breastfeeding. Observing them closely, I questioned the social norm of imposing rigid restraints until I became convinced that controlling my children was not in their best interest. I could see with my own eyes that they were not "spoiled rotten" brats and certainly not sissies. I did not need to manipulate them, or mold them into perfect human beings; they already were perfect human beings, each with a unique set of feelings and needs to be respected. Nor did I need to impose suffering on my children "for their own good" in order to feel like a good parent.(1)
Now my children are older,
and my perspective has broadened. Taking an honest look at a world rife
with violence, hatred, and suffering, I cannot help but question the
common practice of imposing discipline on children to toughen them for
the cruel world. Could there be a fundamental error in this type of
thinking? Might the methods used to control our children be an essential
part of the problem? I wonder if Saddam Hussein's mother engaged in
demand nursing . . . I wonder if career criminals or residents of death
row got to nurse on demand...
(1) The proposition that misguided childrearing produces violent, unhappy and suffering children is addressed eloquently in Alice Miller's book For Your Own Good: Hidden Cruelty in Child-Rearing and the Roots of Violence, 2nd ed., trans. by Hildegarde and Hunter Hannum (New York: Farrar, Straus & Giroux, 1984).
These articles originally appeared in Mothering Magazine in 1995. We thank them for allowing us to reprint them.