Ouch! That hurts! A postpartum doula’s guide to supporting breastfeeding families.
by Feyza Celik, Doula School Alumni
“I don’t want to do this anymore! This is just too painful.”
I am sure some of us doulas have heard similar protests -rightfully so- from dear breastfeeding parents who may be suffering from the agony of difficult breastfeeding experiences.
Supporting families in having the best experience they could possibly have with their newborn is high on the list of a doula’s goals. Yet, because parenting is such a profoundly intimate and personal experience, we definitely do not want to be in a position where we impose a particular pathway for the families we stand beside.
So when we hold space for parents who simply want to give up, it’s hard not to have empathy as we notice their cracked nipples, trying to heal their bodies while taking care of the life of a newborn baby.
You know of the incredible benefits breast milk offers the baby, yet you also have a deep respect for the bodily autonomy of the parent, and feel a little helpless in bridging the gap between the two conflicting realities.
It’s so hard, isn’t it?
What if there was another way?
What if there are meaningful steps you could take to guide families if indeed they did want to breastfeed their babies?
In this post, I offer a guide for doulas on how they could support families in their breastfeeding journeys.
Step #1: The basics
Many doulas, especially if certified, already have some level of knowledge about the basics of breastfeeding support under their belt. This may or may not include:
- Making use of The Golden Hour (The Thompson Method)
- Lots of skin-to-skin contact
- Lots of water intake and proper nourishment (referral to a perinatal nutritionist or lactation consultant if needed)
- Latching basics
- Positioning baby
- Referral to lactation consultant or pediatric dentist for tongue and/or lip tie diagnosis and more advanced support.
These basics are meant to help many families improve breastfeeding. But what if some of these options are not accessible, or what if they have been tried with little improvement? The following steps will provide further ideas about how doulas can help families with breastfeeding.
Step #2: Understanding the nervous system – physiological root causes to breastfeeding challenges
The nervous system is the central information hub between the outside world of experiences and the body. For example, the amygdala is the part of the brain that processes all emotional experiences, and is formed around the time of conception. It is directly connected to the nervous system, which impacts not only a person’s psyche, but also their hormones, physiological structure, and immune system. The body is one unit!
Babies are no exception to this human experience.
Babies are very sensitive to their physical environment, which starts from their time in the womb. The spaciousness of the womb is dependent on how balanced the pregnant body is. Unfortunately, modern society does not serve the wellbeing of pregnant bodies. We sit a lot these days, we drive a lot, we lean on one side of the body, we lean our bodies in suboptimal ways while sitting, and overall live in a more stressful lifestyle which tenses our bodies up as well.
All of these can lead to imbalances in the pregnant person’s body, which limits the space that the baby has while in the womb. In turn, the baby’s body becomes increasingly tense, which can originate from tension in the pelvic floor, back, shoulder, and neck muscles, and impact the baby all the way up to their oral structure (Gillespie, 2022).
So if a baby has difficulty breastfeeding, we can gently invite our clients to consider ways to support their baby’s nervous system through bodywork.
One way to introduce this concept simply to your client is by suggesting your client to point out how it feels like the baby is biting down on the nipple with their jaws, and to think about a time when they felt particularly tense.
“Do you remember feeling pain around your jaws, grinding or clenching your teeth, or just general tension around your jaws? Would you say it was when you were tense? Would it resonate with you to think about whether your baby may need support in releasing some tension in their body?”
This conversation may then lead to questions about which bodyworker they can go to in order to get help.
Here are my suggestions.
Ideally, our clients would want someone who has training in addressing the fascia AND someone who has training in pediatrics. Some options in my order of preference are:
- Gillespie Approach – Craniosacral Fascial Therapist. Clients can join their Facebook group to ask for or search for a practitioner near them (https://www.facebook.com/groups/128162437281535).
- Dynamic Body Balancing Facilitator. Clients can find someone near them on their website (https://dynamicbodybalancing.com/dbb-facilitators).
- Myofascial release therapist. Clients can look up therapists from their directory (https://www.mfrtherapists.com/).
- Craniosacral therapist. Clients can look up practitioners from two different directories. (https://iahp.com OR https://www.craniosacraltherapy.org/rcst-member-directory).
- Webster certified chiropractor. Clients can find chiropractors with training to treat babies and pregnant people through their directory. (https://icpa4kids.com/).
You may also know of bodyworkers in your area! Feel free to get in touch with local midwives, doulas, or lactation consultants for their recommendations.
Addressing the body by releasing physical tension is a wonderful way to help the baby heal and have an easier time with breastfeeding.
Step #3: Understanding the nervous system – emotional root causes to breastfeeding challenges
In the previous step, we talked about addressing the nervous system on a physical level. And what about the emotional level?
Babies are sensitive not only to their physical experiences, but their emotional experiences as well. The pregnant parent’s neurotransmitters, including happiness, love, and stress hormones all impact babies’ emotional wellbeing significantly.
Furthermore, babies are also deeply affected by their birth experiences, the way their parents respond to their needs, as well as situations of under and overstimulation (Solter, 2022). They feel deeply, and express themselves deeply.
According to the classical attachment parenting style, crying is the foundation of communicating needs to the parent. I would like to invite my fellow doulas to consider whether they resonate with the idea of an additional function of a baby’s cry – which is its stress-release function.
The stress-release function of a baby’s cry was first understood by the developmental psychologist, Aletha Solter, PhD. According to her works, babies need to be held in the loving arms of their caregivers in order to release stress and tension from their bodies. She calls it the crying-in-arms approach, and explains that sometimes, babies need to cry in the loving presence and arms of a caregiver in order to be able to improve breastfeeding outcomes.
I believe – from my own experience as a parent and doula – that this beautiful way of understanding and supporting babies can help improve not only breastfeeding outcomes, but also their sleep, and overall mental health in general. Furthermore, it can help parents feel more empowered when their babies cry after ruling out all physical stress factors. It is not their fault!
One way you can introduce this idea to your client is by asking them,
“Now that we’ve made sure all of your baby’s physical needs are met, would it resonate with you to listen to your baby crying in your loving arms? Perhaps they feel the need to cry while you hold space for them so that they can release stress from their bodies. How do you feel about that?”
Helpful Tip: One way to address both the physiological and emotional root causes of breastfeeding challenges in your client’s baby is by supporting your client in doing birth simulating or trauma massage on the baby. They can gently massage their baby, starting from their outer limbs and working their way inwards. They will know they are massaging a traumatic space when the baby suddenly starts crying at their touch there (e.g. the neck may connect a baby to difficult feelings if the umbilical cord was wrapped around their neck during labour/birth). You can gently support your client by inviting them to hold their baby while the baby’s tears flow. The work is done when the baby no longer cries at the touch there. This is also a great option for families who cannot afford bringing their baby to a bodyworker.
Another way to initiate touch for better body coordination (including breastfeeding) is by looking into Newborn Movement Academy, which can be found here.
Doulas play a powerful role in the lives of their clients as they form a bond with their newborn. I hope that the information written here can be helpful to provide meaningful support to your clients so that they can feel empowered in their feeding journeys. Every parent deserves the best support – and you are an amazing doula for being a source of such support.
Remember, sometimes, the best help is emotional in nature. Perhaps all your client needs for now to be able to continue breastfeeding is a loving shoulder to cry on. Thankfully, you are there to hold space for them.
 More information about crying-in-arms can be obtained from her book, The Aware Baby, or on her website at www.awareparenting.com.
Feyza Celik, Doula