Why is Breastfeeding So Painful for So Many Women? LIVE Interview
A Live Interview with Dr Robyn Thompson, midwife with over 45+ years experience, 25 of those years as a Homebirth Midwife. Dr Robyn Thompson is also a breastfeeding consultant, nipple trauma expert and founder of the Thompson Method.
Marie Wilson (Interviewer)
Why is breastfeeding, so painful for so many women, if you're pregnant and worrying about whether breastfeeding might be painful, or if you're breastfeeding and currently experiencing pain, or if you've experienced pain in the past, then you're probably going to want to stick around for the next 30 minutes or so when we hear from a midwife, almost 15 years of experience 60s in the Australian health system, a breastfeeding consultant and nipple trauma expert. And I'm very excited to introduce to you Dr. Robyn Thompson. Thanks for joining us today Robyn.
Dr Robyn 00:43
Thank you, Marie. My pleasure.
It was a little bit dicey at the start there, but we got we got there on time. Robyn, it's really great to speak to you because you have such a vast spance of experience. But today, we're just going to focus mostly on the pain that a lot of women associate with breastfeeding, even if they might not have necessarily experienced that in the past. Based on your experience, what would you say would be the most common reason why women may experience painful nipple trauma?
Dr Robyn 01:25
Well, if I refer to my research, which was statistically significant in breastfeeding complications, in particular nipple trauma, that was the most common then there was, the next one was mastitis and engorgement. So each of those things are connected, of course, because the breast is at that time, preparing the volume, to peak around the third day, third, fourth day, if the baby's actually feeding, depending on the event, it really all depends on the unique circumstances of each mother and her baby, each mother's unique body, her breast, her nipple, and her baby the connection. And, and so nipple trauma was the most common. So there were 78% of women who had, might have been 72, now the old brain's a bit in cognitive. But it was over 70% of women who had nipple, trauma. And then with me sitting beside them in their home, not touching them not touching their breast or their baby at all, just gently talking with them, that 85% of those women were able to breastfeed with a reduced pain or without pain. And so that's what started me very, very interested in what we were doing as practitioners in as people in their professions, with women and their babies.
And so in that experience, so when you were observing these women breastfeeding, what was sort of the main reason why they were experiencing the nipple trauma?
Dr Robyn 03:14
Because they had been taught to hold their baby, by the base of the head, neck and shoulder, the cranio, cervical spine, and because that is so connected to the unique baby's oral cavity, to the unique oral cavity, and to the design of the newborn babies or oral cavity, so newborn and young baby, as they grow, it changes. So they were the main reasons for forceful breastfeeding, you know, shoving pushing, grabbing the breast, in what was claimed to be the hamburger hold. And once that was not done any more, and I asked them very quietly, would they just like to try something else? And they did. That was when the outcomes were changing.
And those forceful techniques. They're still being taught today?
Dr Robyn 04:12
Yes, the women informed me of that all the time. There are some people, there's some professionals now who are not doing that. But there still are many doing that and the feedback either in writing or in verbal information from women, tells me that there's still a significant amount of that practice going on.
And I know when you're talking a lot, particularly when you're talking a lot to pregnant women, you know, one of your aims is so that women can be educated so that they can empower themselves, particularly when they're going to give birth in the hospital system. And we talk a lot about the rapid processing of the hospital system. Do you think this rapid processing also contributes to some of these painful complications?
Dr Robyn 05:05
I think that's part of it. Yes, I think also, it depends on how people have been educated and practised over a period of time, the rapid transfer through hospital is is significantly hard for the professionals to because they have limited time to spend with each unique woman in their duty of care. So you know, duty of care says we must provide a duty of care. And many times there, they found themselves not able to find the time, because there's not enough people there or the processing is so fast, in through and out of the system, that the woman is then, you know, in the difficult position of having to face all those things. When she gets home, which is fairly quick. Even now, even after abdominal surgery, they're home very quickly, much quicker than they used to be.
And that's part of the problem too, because it's a catch 22 though, though, the hospital system sort of wants to move them through, because there's women coming after them. But then some of these women aren't necessarily ready to be going home.
Dr Robyn 06:11
Yeah, and it's quite different with women who give birth at home, because there's not the hurry. And there's not the processing and the mother and baby are generally you in touch with each other immediately at birth, very few that out. And they actually, you know, they're doing what the instinctive mammal mother and baby do together, and just quiet observations by the midwives that are around them, offering their wonderful support. So there is a vast difference in that too. And that's how really I learned so much more. Home birthing with women over a quarter of a century, seems long, doesn't it? And home birthing with women all over the place, not just in one state or one area, I used to travel for women wherever they needed to be. They taught me so much more about what a mother and baby do together. When there's unnecessary interventions. A baby's APGAR score of seven or more, there's generally no necessary intervention. So when that happens, there's very few mothers or babies that run into any problems.
Yeah. And what sort of, so if there is a woman in hospitals just had a baby, it's, it's not. I've seen a lot on social media where, you know, other people offer their advice. And nonprofessionals most mostly other women, you know, based on their own experiences, and I've seen a lot of women, one of their first instincts, when a woman say, you know, hurt, she's experiencing some discomfort that they often will say, you know, have you had your babies had baby check for ties? Now, I know you don't like that language at all. But because it's something that a lot of women experience, what sort of words of wisdom could you offer for them?
Dr Robyn 08:16
Let me just say I need to speak from my own experience with babies that have been labelled with ties, and I do not use the word ties, they are not ties, they are frenula. And when you look at the anatomy, frenula is right in many other places of our body. But we don't delve inside to cut those unnecessarily. We don't cut them really unless probably surgery is going on inside. And I have seen I can't tell you right now. But we do have statistics on how many babies I have seen that have not had a problem. And particularly from birth not had a problem with breastfeeding. Even with a frenula that's prominent. You know, frenula are there, designed for that unique baby and the frenula under the tongue makes the tongue muscle function in the way the baby needs it to function. And it has been functioning with that in utero, in the uterus drinking all of the time. And we know babies when they're drinking, they actually have the hiccups. So by having the hiccups we know they've their hydrating and so they're using that tongue muscle before they're born. And so if if we could just understand the connection between the cranial cervical spine and the oral cavity and the unique baby and the unique mother it has to be looked at on a unique basis not by being taught that everybody does the same thing and frenulas cause problem for every baby they do not. If you see a frenula that may well be not a problem unless, probably there's a family history of an outstanding problem that may need help, but certainly not the newborn and the young baby. Breastfeeding can be achieved in my experience without having to do anything at all. It's about watching, working with that unique mother and seeing what's going on so that you can help her fine tune it to what's right for her not what's right for everybody else. But what's right for her.
Yes, absolutely. Because, you know, we see lots of lots of women getting confused with, and overwhelmed with all these, conflicting opinions and everything. You touched on fine tuning before and I know that you've given lots of presentations of your work and your research your PhD research at various conferences around the world. And now I know you talk about fine tuning and face to breast symmetry in your pain free masterclass. So, when you when you started working on your PhD, was it what was there an aha moment when you worked out that, you know, you're able to visualize sort of what was going on inside breastfeeding babies mouths?
Dr Robyn 11:08
Yeah, I have one of those brains that has to know the answer, that I keep asking questions and why, you know, why is this happening? Let me see. The other question was, why did this not happen to women at home, and they were giving birth at home and they were taking their own babies, and there was very little, you know, intervention between the newborn and the mother. So what was the difference? And the difference was, for me, watching the baby's behaviour, knowing that a baby's being affected by what we're teaching, then investigating that further, having a look at all the anatomy involved with that, and having a look at that close relationship between that anatomy and the oral cavity. And then understanding that newborns in many species, mammal species where there's breastfeeding, all have a particular shaped face to start with. And when we able to connect the mother and baby without touching it, or the mother does it herself in a way that makes the most out or the biggest benefit out of the baby's oral cavity, and her breast and her nipple. And when we get that, then most times, I don't say 100% of the time, because it depends on what trauma is already there, and how painful it is for that mother. But it does make a difference. Because the words are "Yes, that's much better" or "that doesn't hurt. Oh well, you know, it's that sort of approach, I get a little bit tingly when I have for so long been privileged to be able to see the differences in these outcomes.
That's right, because you've, you've worked with so many women who were already experiencing nipple trauma. And, you know, I've seen in some of the videos that they've been generous enough to allow us to share in your education, some of them just saying "Oh, my goodness, it doesn't hurt Yeah. Yeah. Although, sometimes it can be the most gentle of adjustments that can make all the difference.
Dr Robyn 13:26
And you can't, you can't feel their pain you can't feel what they're feeling. So we, this is where sometimes we fall down, because we're so busy is we don't have time to listen. Nor do we have time to really focus on that mother. And you know, the pain of that erectile tissue is phenomenal. So if you're sensing that pain, and hopefully that will stop you in your tracks to work out what, what it is. And that's what it did to me because some of the trauma was horrific. And thankfully, I think I am forever thankful to those women who allowed me to photograph the trauma I was seeing when not long after hospital, they were home. And I was able to photograph that. And that made a huge difference to how I was understanding how the oral cavity function work to because I actually looked at the nipple trauma where it was, how what sort of nipple trauma was, I can't do 100% guarantee I can do it every time, but I have a pretty good idea of how the oral cavity function is working and why that is happening. Yeah.
Well, I mean, you know, with all your experience, I guess, you know what to look for.
Dr Robyn 14:42
Yes. So I have this picture of external picture. I don't have X ray vision. That's the only thing. I'm not Superwoman yet.
Dr Robyn 14:55
So when I get x ray vision, it'll be easier but I have this visual of what's actually happening when I focus on that mother. And that by the end, even when I'm online, sometimes depends on the camera work. And when we have the partners doing the camera work, it's great because I can get much closer, much easier vision. But I can also talk with the mother while she's doing it. So she's seeing it as well. And then she's feeding back to me, I can see the way the baby's lying and I can see the small things that may help when we work with the baby in those circumstances. So again, it's not the same for every woman, we can't make the same decisions. And I keep emphasizing this because so many times, we work on a model that says this is the way you do it. This is how you do it. And that's not the way it works. And I'm thankful for these women who have taught me this because I would have gone along my merry way. Continuing on with that too.
Yes, absolutely. Well, you certainly made a big difference to many women's lives. You know, we've got comments coming in now. And so just I know you don't like all this side of it, Rob, but as a special offer today, if you do purchase the program or in the next 24 hours, you will receive Dr. Robyn’s pain free masterclass as a free bonus in your online library. So if you'd like to take advantage of this offer, just comment hashtag baby bonus, and we'll send you the details. That's hashtag, baby. Bonus. Now Rob, we actually have a few comments coming through. So if it's over, I might just bring them up on the screen here. We've got a comment here to make all of us says “Thank you Robyn forever grateful, from Tamika.”
This is from Noel Nicole, "I belong to several breastfeeding groups. And so many people tell women it's normal to have extreme pain for the first two weeks, you just need to push through and wait for your nipples to toughen up". I didn't come up with this. This is a genuine comment. How would you address this?
Dr Robyn 17:06
Now, it breaks my heart to hear that people would say that to a woman. And I'm going to say this. And I'm going to say this with confidence. Right? If people knew that the the nipple, the tissue of the nipple is so so sensitive. If you can imagine the pain associated with damage to the head of the penis, it's that painful. So why would we want someone - this is my question - why would we want someone to expect to have pain like that for an extended period of time, if we can do something about it. It's really sad that we put that pressure on women. And I would be doing my utmost out there to try to relieve that pain and start reducing it, and then relieve it or reduce it at least to start with. And then to help the healing take place and work out a way with that unique mother, what will work for her in her situation in her family life. Whatever she's doing, it has to work for her too. We can't just make statements like that. I would, I would hate to have to tell someone to put up with that pain for all of that time, if I could do something about it.
And, and so in terms of like doing anything about it, I mean, obviously, it's one thing if you're already breastfeeding, and experiencing that sort of pain it's complete, can be debilitating. And yet, you know, so many women do push through it. And there are ways, with one to one consultations and some fine tuning. But if a woman is worried about painful breastfeeding, then there's actually so much you can learn about breastfeeding. And then she can actually understand it and because sometimes, you know if you've got that belief in your head, and people are saying yes, you just have to expect you have to push through it ...... , there is an alternative.
Dr Robyn 19:14
Can I say also, it's really wise if you can to be more prepared and more, have more information in pregnancy, where that you can take control rather than other people taking control and give you the confidence because you already are an empowered woman. You've just given birth to a baby that's empowering in itself. Being pregnant is empowering, your body changes the whole time your baby grows. So just being confident to take control is something that's really, really important. And I think that information and understanding in pregnancy is really wise.
Yeah, that's right. And I think that the lot more women these days are becoming, they're wising up I think in their understanding that there's a lot of education that perhaps, some of the antenatal classes and what have you may not be necessarily including or they might just be touching on it. So there's so much to learn. And you're better off learning that during pregnancy so that you actually can reduce the risk.
Dr Robyn 20:21
Yeah, I think it's very important, we learn much more about pregnancy, we learn much more about how to work through labour. And we learn much more about being with a midwife. And the midwife of your choice. That's all very important, most important, is having that person there with the other people that you may choose not too many, because it becomes overwhelming. But in my experience I'm talking about again, but you know, if you have your own midwife, and she has a buddy, if she needs a buddy help, that is the ideal way to go. And of course, there are other options, there's midwifery group practices, there's the birth centres really got wiped out by our government not so long ago, many years ago, taking everything away, that makes things much better for women. And we, as a social group, around the world have an obligation to look after these women in a way that they choose to be looked after. Because they are working, growing, working with and developing future generations for their countries. And I think that's really, really important that we consider women has very, very important, in fact, a paid role. Because they're working 24 hours a day, without income, and those that need to go back to work or have to go back to work or want to go back to work, then, you know, it's often difficult for them to hand over their little babies. For others, it's okay. They may have done it before. So they've got a connection, they've got connections going that work for them. But again, it's very important. We focus on every mother, every single mother in the best possible way we can and make her journey, the best that it can possibly be.
Yes well said, Rob. And I know it because you've had experienced both in the hospital system and homebirth system, you have this, I think that's this unique perspective, to have such vast experience in both hospital and home birth. And I think then, would you think that that's probably possibly given you a way of looking at things that's perhaps different from a lot of other a lot of other health professionals
Dr Robyn 22:41
Without doubt whatsoever. My colleague Claire lines, spent many years with me, my colleague, Anne Sprague, we work together, Jenny Perrat. We had the most amazing connections between us, our friend, and colleague and friend, Chris Shanahan, who's no longer with us, she's passed. It was amazing. Our GP, Dr. Peter Lucas was incredible when we needed a GP, Bruce Sutherland, the obstetrician that we were connected with was absolutely perfect. There was none of the antagonistic control that goes on now on one profession, trying to counteract the other person profession and keep them in control. Of course, that doesn't happen everywhere. But it happens a lot. And when you hear the stories, that's when you start to know that there is this something or other that's going on that needs to stop, it needs to stop because we need to focus on the women. And we need to give them the time that's required. And I think the only way we can do that is for us all to unite. Wherever we are with with pregnant labouring, birthing women around the world, we need to unite and we used to we need to say, Enough is enough. We've had enough of this.
That's right. Because a lot of the time it's the women who suffer. Yes,
Dr Robyn 24:02
That's right. Well, most of the time, it's the women who come out the other side of it with, with things that they carry often for the rest of their life, you know, it's something that it's deep within them. And we wonder why there's so much postnatal depression. If we were gentle, we were calm, we were nurturing. We were respectful. And we embodied them in the whole process, in a way that it's their, it's their baby, it's their body. It's not ours. We are there to be there helpers and with the knowledge as well, we come with knowledge we come with experience, and then we have responsibility to pass that knowledge and that experience on to our junior colleagues who are came absolutely, to do what a midwife does, and we need to be passing that on to them too, and being by their side, the same as we had that when we weren't developing and growing in the profession, too.
Amazing. So let me see if I can review the key points that we talked about today. One of them was to become well informed before you give birth to your baby so that you can go into the hospital system, assuming you're giving birth in the hospital system, knowing and understanding your rights and also understanding the principles breast milk production, that's a big one, isn't it. And of course, when it in relation to pain, avoid holding your baby by the back of the head, neck, or shoulders. And then do not allow anyone else to hold your baby by the back of the head, neck or shoulders, and then particularly force, force the baby to the breast.
Dr Robyn 25:48
Yes, that should never happen. Because the analogy I use there is imagine if someone held you by the back of your head, and that's an adult hand on an adult's head, if you have an adult hand on a baby's base of skull, and you shove that baby, or you shoved that adult to a piece of steak on the plate, what are they going to do? They can't do anything. And the mammal baby is not meant to be treated that way. No other memo on the planet that I've observed in my observations during my research, were doing that to their babies. So I think we have to review what we're doing and how we're practising. And also we have to look after our professionals who are practising in difficult situations too. We have two primary concerns about what they can do to fulfill their duty of care and to be responsible and accountable as the law says we have to be.
Yes, that's right. You were saying before that we might all have to go on strike again! What year was that?
Dr Robyn 26:52
1986. The Australian Midwifery Federation, it was actually I don't think it was the AMF then I think it was the ANF then, the Australian nursing Federation then, but now we have been combined, but I'm looking forward to the day when Midwifery is separate from nursing because they are two separate professions. And, midwifery is a profession in its own right. So I'm looking forward to the day hopefully before I move on from Mother Earth. That, you know, we will get to that point where we have our own leadership and then we can move on with the things that we need to do. The same is the obstetricians have their own leadership. Nursing has its own. Midwifery has its own. Makes sense. Yeah, okay, sorry. I got a bit carried away then.
That's good. It's a passion. That's what it's all about, isn't it? We need the passionate people in in positions where they can actually make change. So it's, I think it's fantastic Okay, well, thank you so much. Can I just say one more thing?
Dr Robyn 28:00
Please, I would like to congratulate my dearest colleague, a longtime friend and midwife whose home birth hospital birth, done everything, including education of midwives, has received her PhD after seven hard years. She's got it. And I would like to congratulate her today, Carolyn Hastie. And if you want to find Carolyn on her website or on her blog, ThinkBirth blog, then you will enjoy everything she says. She is one amazing midwife. And I'm so happy for her.
She's an especially lovely person as well. Experienced like you. And yeah congratulations.
Dr Robyn 28:48
Amazing papers for publication. And if you don't want to read a paper, you can just read the abstract. But my professor Sue Kildea has just published another paper. And it's been it's travelling worldwide. And I think all of these things, even if you had time to read the abstract would give you the impetus to say, oh, oh my goodness, and it's that's to change the thinking of the routine that we're under when we are conformed to follow the way things go for other people but not for the woman themselves. So I really think that there are quite a lot of papers Charles Darwin university that I'm sure that will be there. I just can't think quickly now to where. Amazing papers. So congratulations, Carolyn. We are all proud of you. and wonderful.
Thanks, Robyn. Well thank you for your time today and sharing your experience and your wisdom with the wonderful women on your Facebook page and out there and in Facebook land and I look forward to the next time we have the opportunity to chat.
Dr Robyn 30:03
Thank you for chatting with me. Take care, everybody.
Dr Robyn 30:07
Stay strong. Stay in control. It's your baby. It's your body and you can make the decisions most of the time. Sometimes you may need help, but most of the time. Take care. <end>
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From all of us at The Thompson Method team, happy birthing & happy breastfeeding.
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