Why breastfeeding is a lot like sex for a first-time mother
Breastfeeding. "It is a bit like sex" I thought to myself, early one morning.
a.) It does not ever happen the way they show it in the movies.
b.) You can’t really learn by watching others do it.
c.) You really don’t know what it is going to be like until you do it.
Further,
1.) It involves your body and one other person so intimately attached to you, whose body you will be acquainted with in great detail.
2.) It takes practice to get to be good at it and every baby is different, just like every lover, so there is the matter of fit, though breastfeeding ends up getting (and also needs) more frequent practice, which often means that skin gets chaffed and it hurts. There can be infections and it can hurt a lot.
So really, it is a lot like sex for the first few times.
It is not everyone’s cup of tea though, this attaching and feeding another person from your body. I suspect there are people who feel similarly about sex but one does not get to hear about it as much, or at all, in fact.
One new mother confided in me that while feeding her infant son, being skin to skin, with scarcely a breath to part them, she became acutely aware of how intimate their relationship was. That she understood his communication through his movements and sounds, through his body, at a level of detail that would never be possible in any relationship other than a sexual one – if we were lucky.
It would also cease to be this way once he was weaned off the breast; that from weaning onward they would only get more and more distanced from each other; that one day he will have a relationship with someone else, one she will not participate in. I thought I saw her eyes mist over at considering the prospect of losing this intimacy with her son, illogical as it may seem from where they were currently placed, still breastfeeding. She valued this stage of their togetherness such that the impending loss was acutely felt.
Not so far removed from feelings in a romantic relationship, I thought—the fear of loss, the gnawing envy, the anxiety of being neglected are so familiar. And yet, she is not crazy. Just honest. She is putting into words what many mothers experience and know to be true. Silently.
Taking your clothes off, or intimacy regardless of one’s state of undress, requires one to be vulnerable and who to be vulnerable with is a large part of the comfort or discomfort. As a matter of fact, there are few emotional states more vulnerable than a new first-time mother. That is, except her newborn baby. The little baby is definitely more at risk but then again, this is not a competition. Mothers are terribly delicate in the first few weeks after birth, both physically and emotionally, and a large part of this state of mind is useful because it helps her to identify with the baby, to imagine, even experience what it feels like to be small and needing a lot of care and responsiveness. It does not make it easy for her though.
The pregnancy itself brings up so many feelings and memories from the past about significant relationships and feelings towards loved ones — loss, abandonment. It is as if the new baby inside you makes you a conduit for feelings across generations. Your relationship with your father and mother come swooping in through you; in your day-dreams and night-dreams, you are assaulted sometimes by memories you did not know you had stored away somewhere. It is as if the baby growing inside needs to become connected to the internal theatre of the mother and all the rest of the cast.
The memories and feelings link grandparents, dead or alive, to this new baby, through the mother of course. This internal drama is most evident to the mother and because it is accompanied by changes in her physical body and her mood, she has the choice to dismiss it as "just hormonal" or attend to it as a valuable reality. A reality less tangible but no less powerful; a reality that underpins the feelings with which a baby is received into the world; how the prospect of labour is made bearable and hope overcomes the inevitable anxiety of death that accompanies every pregnancy.
So here we have two vulnerable people, one of whom has to get their act together enough to be adult at the same time; to envelope a tiny thing in her arms, despite pain and oozing blood; while trying to not be overwhelmed by a multitude of opinionated onlookers, contort herself into awkward positions to peer at her chest for hours every day, try and try again to give this baby something she is told is invaluable. Not really like sex anymore.
***
But why get into all this, to begin with? Why spend all this word-count on this subject of breastfeeding, I asked myself. Something in my dream or in the conversation the previous night or from the depths of my unconscious had woken me early one summer morning with the thought that "breastfeeding is a lot like sex".
As I stumbled to my computer, thinking "maybe I’m onto something here and I had better write it down before I forget", the grey Delhi dawn felt only too familiar, too similar to the grey dawn outside my window when I would be awake feeding my own babies. I noted that there had been just the two of us. No one in the world would have been aware of what went on for us had I not told them. And yet, what went on between my baby and me was beyond words. Before words. It could only be felt, not said.
My husband, who never abandoned us for the comfort of another room and an uninterrupted night’s sleep, would often try to wake up with me and I was grateful for his company. It meant there was a witness to our experience. While I was sitting up, calming a small person and putting her needs before my own, his presence made me feel less lonely. From being something the baby and I experienced in isolation, almost in secret, we became a family. (This, despite my practical mind being aware that two under-slept, groggy adults did not make for very efficient bread-earning, housekeeping or childrearing.)
I would be torn between putting him back to sleep and prodding him with my toes to keep him awake. There was a warmth in being kept in mind, to have him be aware that he was part of something important going on. For this reason, beyond the science of nutrition, immunity-building, and cognition, for the emphasis on the relationships being formed and being re-formed, I place this emphasis on breastfeeding. Because it needs to be kept in mind — every mother and what she does, in the most ordinary and neglected of experiences that help to form the fundamental building blocks for our capacities for relating to others, needs to be kept in mind.
Depending on where in the world one is located, whether rules of protecting the mother-baby pair from nazar operate or not, the multiple onlookers can include the near family, female neighbours as well as nurses and doctors if one is in a hospital. Their frequent peeping suggests that as soon as you have pushed a person out from between your legs, all the rules of social decency are out of the window. These onlookers come complete with opinions, of which there are plenty too, on everything from what to eat and what massage oil to use, to how to get the baby to feed or sleep, which keep changing (which is really annoying as well and hard to keep up with).
They have changed their tune towards breastfeeding too. It was perfectly okay to use a powder that came out of a box to feed your baby some decades ago but then the World Health Organization said "no actually it’s not", so now if a woman is not a calm perfect mother who breastfeeds till her child is going to nursery school, she is liable to be judged by her peers and suffer pangs of guilt and inadequacy.
For me, this does not come from a "grapes are sour" perspective. I was very keen on breastfeeding and did not think there was much to it. How wrong I was! I underestimated how powerless and "un-able" the combination of physical pain, blood loss, hormonal whirlwind and emotional rough-and-tumble would make me feel. And of course, I had forgotten to take into account the fact that my baby would have an opinion too. She did.
She was pissed off that the milk did not flow immediately as soon as she sucked and would scream and yell, shredding my already stretched nerves. My valiant husband, without whom I would never have coped, would pick her up, walk around the room with her and sing to calm her down and pass her back to me so we could try latching on again. (Years later I see how these responses are actually quite typical of our respective personalities, all three of us. But that is a different story.)
This went on for three days, every couple of hours, day and night, where a tiny person of barely three kilograms in weight had four adults spinning with anxiety. I was miserable, our baby was probably hungry and we were both exhausted. The midwife who was visiting us at home tried to help us get the latch right by shoving the baby’s head onto my breast.
Of course, it did not work: shoving is no good, for sex or for breastfeeding. After trying this for five minutes each on two successive mornings, she declared that breastfeeding was very difficult anyway, she had not been able to do it either and in any case my nipples looked like they were the wrong shape so I should probably give up and give the baby a bottle since she was losing weight.
Perhaps she was trying to be kind to me and perhaps if I had been less eager to breastfeed I may have jumped at the thinly veiled permission she offered. But I was not. I was hurt and offended at the suggestion that there was something wrong with the "shape" of my nipples. I was angry that she was useless at her job and I wanted to get rid of her. I could do neither; instead, I cried a lot. My adult, professional brain had become defunct and I just could not gather the strength; in fact, it did not occur to me that I had any strength.
After the midwife left I called (and possibly blubbered to) a friend for help and either because I knew and trusted her or because she was not jaded, opinionated and rough (and shoving), I felt relaxed in her presence. Watching me hold the baby ready to latch on to my left breast, mid-conversation, my friend very gently, almost imperceptibly, tilted the baby’s head a tiny bit back from the position I was attempting so that instead of being parallel to the breast her face was ever so slightly turned upward.
That was all it took, a subtle change of position. My frustrated, hungry four-day-old latched on and had her first proper feed. I could tell the difference in the way her mouth felt on me, I could feel fluid stinging and flowing inside me and it became immediately obvious that we had had it wrong all along. We were off! I eventually breastfed her till she was a one-year-old without incident.
Misshapen nipples. As if!
It got worse before it got better though because the morbid midwife arrived the next day, with a student in tow, not having asked me if it was okay to increase the number of strangers staring at my apparently misshapen nipples and non-milk letting breasts and made further dire declarations. This time it was about the baby having lost too much birth weight and needing to be taken to the hospital, but that is another ghastly story we don’t need here.
And yet, it is a ghastly story that is only too common and one that does no favours to the developing breastfeeding relationship. Having a newborn baby in a neonatal intensive care unit, being prodded with needles and a feeding tube through the nose, you can perhaps imagine the soul-battering wrench it creates for a mother and new baby. Nine years later I still shudder at the memory.
On the other hand, if rules of nazar do operate, then it is unusual to get near enough to the mother-baby feeding pair long enough, quietly enough and unselfconsciously enough to actually be able to observe what is going on (though the ruckus created in the "multiple onlookers" scenario is not conducive to quiet reflective observation either). On the rare occasion when I have been privileged enough to be invited to quietly observe a baby feeding, I am struck by the extraordinary capacity a tiny baby and new mother have to communicate with each other wordlessly.
Baby Aman’s mother was comfortable enough with me to have me in the room while feeding him. At five months, Aman had clearly had enough experience of joy and satisfaction at the breast such that when his mother picked him up to feed him, he gurgled and giggled with the excitement of anticipation. Somewhere between a cry, a laugh and a song, he seemed to smile with nervous anticipation. Perhaps nervous in case it did not actually materialise.
But when it did, he latched on to the breast with such practised ease, that I realised a five-month-old is a veteran at this business of working for his supper. Sucking hard for the first few minutes, he broke off from the nipple to look directly and intensely at his mother. She looked back at him, nodded as if to unhurriedly, gently ask him "what?" and letting him take his time, smiled at him. They were communicating in that silence. There was deep love in that silent gaze.
When he had filled himself with the sight of her, he returned to the feed.
There is no one right answer that works for everyone. One truth is that breastfeeding is also a bit like learning to ride a bicycle or swim. Once you get it, you can’t forget. But it is also true that you need help to get it right (just like riding a bicycle, swimming or sex) and many women don’t have the right kind of help especially in urban settings if they have not been around other breastfeeding mothers very often.
Once you can do it comfortably (which takes a few weeks of practice the first time), most women find it very convenient. It is certainly less fiddly than bottles: nothing needs to be sterilised, it is always at the right temperature, available at all times so there is no wandering about in the dark between bedroom and kitchen for the 3am feed; it is created by biofeedback so there is no worry about "how many ml should my baby be drinking at this age", etc., and no wastage. Baby starts, baby stops for burps and has some more. Mother relaxes and trusts the baby. All good.
There is always the other side of course. Breastmilk is perfect food so it is used up very quickly, which is a pain-in-the-you-know-where for the mother because the three-four feed schedule means zilch. It is a huge commitment to being present. It also needs you to take your top off or expose yourself somewhat and that, in urban India, is not very easy or comfort-creating.
The baby has to be with you all the time because you never know when they need you or you need them or you will start to overflow and leak if you two have been away from each other too long. It is best done if there is little else that needs your attention for the first six months, which sounds ridiculous said out loud because there is rarely such a thing.
What I am referring to here is less about social discomfort and more about an internal one. A lot of it has to do with closeness and distance. How close is intimate and when does it become intrusive? How close is suffocating and makes me want to recoil? As a new mother, am I ready to change my life around completely and devote it to another person, even if they are tiny and need me for survival? Or do I need my own space sometimes so that I can remember what it used to be like to be me?
It is exceedingly and distressingly common for a baby to be unable to feed at the breast in the early days. Often it is not because of an inherent inability in the baby or mother but an outcome of the baby’s struggle to meet his mother’s attitude to feeding. Many things interfere with the mother’s capacity to adapt to the baby’s needs. Many things, potentially, as we see above, but mainly self-doubt, medicalisation, anxiety, depression or illness or feeling not-looked-after and there is nothing more destructive to breastfeeding and latching on than anxiety in the mother. Many emotional/mental health relationship issues are a matter of degree — how anxious? How depressed? How ill?
Ironically, for a first-time mother, anxiety is a given. Most of us are overwhelmed and uncertain about our own capacities, at least some of the time. Perseverance and a kind assistant can really help, all the latest research says exactly this. At other times, advice to persevere with breastfeeding is disastrous. A transfer to the bottle can be a big relief for both and can actually rescue their relationship. Maitreyi lost her own mother at the age of eleven and always cherished a desire to be a "very good mother" to her own children.
Breastfeeding them was part of that ideal but getting her baby to latch on was excruciatingly difficult, painful and frustrating. Her breasts were engorged, the nipples were not ready, the baby was hungry and her nerves were stretched. At the age of three days when her baby was put in Intensive care to attend to her rising bilirubin levels causing infantile jaundice, the little reserves Maitreyi had were shattered. She could not eat, sleep or be looked after herself, stuff a new mother needs to be able to make breastmilk.
The anxiety in her, the distress in the baby all compounded to make her more uncertain of her capacities to provide for her infant. "No one was putting pressure on me, my husband was so encouraging, telling me to try again and again but the baby was hungry, no one was able to sleep, the milk was not enough and Anya was not latching on because my nipples were not formed properly." Being a medical doctor herself made no difference to how vulnerable, anxious, exhausted and uncertain she felt.
She recognises the self-blame, the pressure on herself to be a particular kind of mother, her feelings of having failed her baby. Eight years later, as she recounts her ordeal, her eyes mist over and I find a tear rolling down the side of my face as I listen to her. Even as she tells me how her husband’s voice was a reality check—that she can be a perfectly good mother with a bottle full of formula, that there is more to their relationship than milk—a part of her is still in pain.
Plenty of first-time mothers, usually years later, have confessed how they hated the breastfeeding experience. Some gritted their teeth and endured it, some expressed milk, one courageous woman I knew expressed every single feed for six whole months; others gave up after the first few weeks and were relieved. Breastfeeding made one woman so unhappy and depressed that her doctor suggested she stop. She was much happier after that, finding that her relationship with her child improved vastly.
The early feeding relationship is the template for later ones, especially to one’s own needs, body and capacity to trust the outside world. Success at breastfeeding does not mean that all problems are solved but it does mean that the baby will be introduced to a more intense and rich experience in human relationships. Something very powerful happens between two human beings during feeding and has an immense impact on the child’s developing capacity for deep intense relationships, which are laid down in us as our wiring, at the level of connections between neurons. However, and this is the crucial part: a lot of problems are created between mother and baby in the feeding experience because we take the words "breastfeeding" literally.
In psychological writing, the term breastfeeding means "the kind of care that goes with personal attention from the mother. Actual breast milk is not necessary, the mother can bring up her infant perfectly well without it. Everything depends on ‘her way of doing it’. Being lovingly held is the greatest spur to development, more so even than breastfeeding. Breast or bottle, if done mechanically, without being in tune with the baby’s need, without responsiveness to frequency, quantity, speed, discomfort and closeness, harms the relationship the baby has with food, with nurturance and eventually with love." This means, only a mother, or other person looking after the baby, who is in tune with the baby can decipher the code of whether a particular cry is about hunger, a need for holding, pain, anger or boredom.
The vast majority of feeding difficulties in babies and children have to do with the immense problem that every mother has in adapting to the needs of a new baby. She has to do this on her own because no two babies are alike, and in any case no two mothers are alike and one mother is never the same with each child. The mother cannot learn how to do what is needed of her, either from books or from nurses or from doctors… The main things that a mother does with the baby cannot be done through words.
If breastfeeding is love, fantasy and satisfaction, then weaning is where rage enters, along with grief. The first true separation and the quality of it, the gains and losses from this first big upheaval, form the template for responses to future separations. Aman, at the age of 14 months is down to three breastfeeds in 24 hours. He is being weaned from the breast and steadily engaging with solid food that helps him join the social gatherings at the dining table.
He has a few teeth and loves pasta, pumpkin, chapati, rice, stewed fruit and many other foods. He has started walking, is deeply interested in exploring the room, the house and the worlds that he now has access to from his full height of just over two feet. Yet, his mother reports that when he sees her he will stop his exploration and look at her with sadness and reach out for the breast. She is very aware that she too is sad because feeding Aman used to be such a special, uninterrupted time for them together. And now they have less of it.
No one can tell her when and how to wean. "The wish to wean must come from the mother". Only she, in interaction with her child, knows what else he is ready for in the outside world and how changes have to come in a bit at a time, to make it manageable, because "a weaning from is also a weaning to".
She provides a stable setting for this process, avoiding travel, change of nanny or moving and focuses on that which she knows is hard for Aman but one on which he will grow and extend himself. Of course, he is not growing forward at all times. By the time the day is over and he is tired, he is a tiny baby again, wanting to be held and carried and nursed to sleep. Growing up would be unbearable if we could not go backward every so often and be cared for as if we were truly very little.
By the time a baby is nine months old, he/she has had more than a thousand feeds at the breast and has a trusting relationship with it, as a representation of the world, that provides satisfaction, survives anger, greed and destruction (let’s face it, babies are often fierce in their demands at the breast as if they would devour it. In imagination, they perhaps do so every day). This is a huge achievement for the mother-baby pair and a relationship to the world that starts well has a good chance of going on well. If the feeding itself has gone well then there is something worth being weaned from. All good things come to an end and that is what keeps them good in memory.
We all carry the traces of being cared for in a particular way somewhere in our minds and in our bodies and that is what we dredge up when we feed our own children. If a mother can bear the anxiety generated by onlookers’ judgments, competitiveness about the baby’s weight and rate of growth and just trust herself and her baby’s communication, about feeding, they will be the richer for it.
It is only possible to be maternal (which includes the man’s capacity to be caring) by a high degree of identification with the baby while maintaining one’s adult status and remembering that what is required is not perfection but an ordinary, repetitive, good-enough responsiveness, complete with human failings. Good Enough. Just that.
(Excerpted with the publisher's permission.)