Adapted from Pregnancy to Lactation: A Physiological Continuum. A talk by Michel Odent M.D. hosted by LLL South West London, Great Britain, 10th October 2017. Write-up by Deborah Hanson, La Leche League Great Britain.
As a Leader Applicant at the time, mother and midwife, I could not resist the opportunity to listen to Dr. Michel Odent speak. Particularly as I have admired his gentle intellectual insight for many years.
Speaking in a beautiful French accent that reminded me of lazy summer holidays, Dr. Michel Odent perched himself at the front of his captive audience and introduced his topic as being very relevant to La Leche League because of the intrinsic link between birth and breastfeeding.
Dr. Odent pieced the jigsaw together in my mind about the neocortex (part of the brain involved with sensory perception and understanding) and times in our lives when its dominance is reduced – such as making love, the end of pregnancy (“baby brain”) and even why human babies are born with the ability to swim. To encourage pregnant women to “live in peace” and remain calm, he suggested avoiding complex conversations at the end of pregnancy and discussed organising groups of singing pregnant women. I am not sure how I will sell that one to my matron (supervisor)! Yet, explained Dr. Odent, by understanding the role of the neocortex antenatally (before birth), we can understand lactation. Difficulties in lactation often stem from delays in breastfeeding–for example the old-fashioned use of hospital nurseries, other caregivers holding the baby immediately after birth, and no skin-to-skin connection between the mother-baby dyad. This need for early togetherness ties in with the LLL philosophy statement “Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply.” The neocortex separates us from other mammals, allowing us the opportunity to be aware of and plan for birth and the realities of having and feeding a baby, but it can also cause us to interfere and create avoidable problems too.
Dr. Odent went on to discuss the science behind what many midwives like myself have noticed in practice, and which is directly reflected in the LLL concept, “Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.” Namely that oxytocin (“the hormone of love”) is more effective in women who have birthed without intervention and have been mobile during birth, compared to women who have had a caesarean or non-mobile epidural. This often has a lasting and significant impact on breastfeeding duration. The feel-good hormone oxytocin is activated when women are active participants in birth.
Following an audience question, Dr. Odent went on to discuss his frustration with inductions of labour for mothers who have gone passed their due date, and the pressure this puts on women towards the end of pregnancy who begin to worry about an arbitrary date. This forces them out of their positive thinking into a world of neocortex-activated panic. The image of a tree growing fruit will forever stay in my mind. Just as apples ripen at their own pace, so too do babies: some babies have dry skin at 40 weeks while others are still covered in vernix (a protective white cheese like substance found on a newborn baby’s skin) at 42 weeks. This seems a particularly apt analogy as the placenta is known as “the tree of life.”
Dr. Odent asked us to reflect on our language, and consider defining terminology more precisely when discussing caesareans. Primarily, is the caesarean a “pre-labour”’ caesarean? This is hugely significant, because if labour has commenced, then the baby has released surfactant, a chemical involved in lung maturity. Dr. Odent likened this to the baby saying he or she is ready to breathe in the outside world. When caesareans are done at the practitioner’s or parental convenience one is instantly omitting the baby’s role in birth. For pre-labour births, the baby will have lower levels of beta-endorphins (a morphine style hormone linked to the milk-producing hormone prolactin), lower levels of melatonin and anti-oxidant properties (connected with prolactin levels) and many have an increase in respiratory problems (due to lung immaturity). Without the correct levels of this cocktail of hormones it is easy to see how this could reduce breastfeeding rates, simply because an arbitrary time for birth has been chosen rather than waiting and listening to when the incredible human body is ready.
In his typical and elegantly poignant fashion, Dr. Odent questioned whether humans have become domesticated? Have we lost our key responses? Do specialist roles prevent us from having a holistic view? What is the impact of civilisation on the choices we are making? For further reading on this topic I would highly recommend his book, Childbirth in the Age of Plastics which considers amongst other things the use of syntocinon, the artificial oxytocin hormone used in induction of labour.
Dr. Michel Odent closed his talk in a creatively genius way by encouraging us all to be bilingual. His French accent instantly seemed more vivid as he spoke to his dedicated audience, but he was asking us all–Leaders, mothers, expectant mothers and practitioners–to be bilingual with the language of the heart and combine it with scientific language. In other words he encouraged us to combine topics we are passionate about, such as breastfeeding, with evidence and meaning. Certainly understanding the role of hormones and the neocortex will be reflected in my practice, and it definitely dominated the conversation on our long drive home.