Guide for Couples' Lactation

Roman Charity
1627-28
Oil on canvas, 96 x 73 cm
Musée du Louvre, Paris

 Realistic guide to couples' lactation

By Mayfieldflower RN

At any given time, I correspond with a half-dozen or so couples who are attempting to induce lactation, most of whom have no interest in a true adult nursing relationship. Instead they arrive at my blog having searched for information in the context of a desire to breastfeed a soon-to-be adopted child. Regardless of intent, the journey to lactation outside of pregnancy is a difficult one, and one that past conversations and experience tell me fewer than half will complete. The successful ones are most often those whose partners fully and joyfully participate.

The reasons the majority of couples discontinue an attempt to induce lactation don't vary that much. Most common is her complaint of sore nipples or extreme breast tenderness, followed by the sheer magnitude of the time commitment for either or both partners. One couple told me that the process of induction "seemed too weird" after they tried it for a day, and another said it made them feel "not as sexy" together (I'll never understand that one). One tearful and very disappointed woman said she simply couldn't tolerate the hormone changes her body began to undergo, and stopped despite her partner's reassurance and encouragement to continue.

As I reflect upon all of this, I realize that there is really no "best practices" guide available to couples who wish to induce lactation together. There is varied information regarding the effects of specific herbs or ways to obtain off-label medications, and random instructions as to a proper latch along with recommendations for breast pumps and marginal support groups, but no real-world, what-to-expect type of information. Thus my contribution to the ANR community today is to post a set of truths about induced lactation which reasonably begin to prepare a couple for the journey.

Note that none of my offerings will apply to all couples, all of the time, nor should they, as every couple and every circumstance is different. My words are, however, an honest reflection of the most common struggles and obstacles encountered in the journey to induce lactation, posted by an RN and certified lactation consultant who is utterly dedicated to the cause.

First, time is imperative. A couple should set aside between six and eight weeks to have the best chance of bringing in her milk. While some rare women have accomplished full lactation in four weeks, others need ten, thus six to eight is the most reasonable expectation.

Most protocols I've seen for inducing lactation suggest that a partner should nurse with a full latch for fifteen to twenty minutes per breast every three hours. It's my experience that this is too much in the beginning and doesn't adequately prepare her nipples for nursing, thus extreme breast tenderness results. Instead, for the first two weeks, nursing sessions should be spaced longer apart in hours to give her nipples time in between to rest, but they should likewise be longer in minutes per session. The stimulation necessary to initiate the first hormone spikes of estrogen, progesterone and prolactin is best balanced with the least nipple soreness with a commitment of thirty gentle minutes per breast, every four to six hours. After the initial two weeks, the estrogen/progesterone spike must be augmented by a steadier release of prolactin, which occurs in response to regular, prolonged nipple stimulation, and it is then that a regimen of fifteen to twenty vigorous minutes per breast every three to four hours best accomplishes this goal. Note that sometimes it is necessary for this protocol to continue for a long as six weeks, every day, around the clock, even if her body seems not to respond at first, and it is during this time that the couples I have worked with are the most easily discouraged.

The next factor in the successful induction of lactation is her body's release of oxytocin. Oxytocin is called many things...the love hormone, the cuddle hormone, the orgasm hormone, the childbirth hormone...and it is all of those things. It's also, however, a shy, tricky, demanding little beast which is quite easily affected by circumstance. If she's stressed, or fearful, or insecure, even at the most subtle of levels, oxytocin production will be inhibited and lactation will likely not occur, or occur with great difficulty.

In the real word, this means that her partner must make every effort to provide a secure and nurturing space within which the process of inducing lactation begins. Rather than one big, certain gesture, however, this is better received as a series of small efforts, tender reassurances and constant encouragement. Most women (myself included) feel very touchy and cuddly when the oxytocin/prolactin cocktail begins to surge; what isn't obvious, however, is that nature designs this reaction specifically to enhance oxytocin release. Skin to skin contact when not actively nursing, something as simple as stroking her chest and upper arms and neck and face when lying together in bed or even when watching television, can dramatically raise oxytocin levels.

It's also true that the body's major stress hormones, including cortisol, inhibit oxytocin release, thus it's important that her partner makes every attempt to shelter her from anger or even difficult conversations during these weeks, bringing her down gently when frustrations arise. With my patients giving birth, I often say that the quickest route to a Caesarean section is for the people surrounding the laboring mother to grow stressed and impatient, and I've been known to toss out of the room more than one person who failed to contribute to the gentle, nurturing, supportive cocoon I create there. It's much the same scenario when a couple attempts to induce lactation together.

It's worth a note here that the necessity for affection, touch, reassurance and nurturing to boost the release of oxytocin is also the reason that I don't recommend a couple use a breast pump more than once per day if they're attempting to induce. Sure, the mechanics are there, and the prolactin release from nipple stimulation will occur, even marginally, but without the corresponding oxytocin release triggered by her partner's affection, cuddling and touch, milk production and eventual milk let-down is difficult. Many people don't understand this and feel that the insert-part-A-into-slot-B technical approach of nipple stimulation, whether from a breast pump or by a partner, should be enough. The truth is, it usually isn't, and this remnant of evolution is simply the way Mother Nature designed women. When an infant is put to the breast, mother intuitively snuggles the infant close, creating skin-to-skin contact, and the baby reflexively reaches out to clasp the breast in his little hands, creating an oxytocin surge and helping to initiate milk let-down. Touch from a partner works the same way; a breast pump does not.

There are other variables which can significantly impact an attempt to induce lactation, including menopause, the use of oral contraceptives and some anti-depressants, and certain medical conditions such as polycystic ovarian syndrome, but because these topics are so vast, I have chosen not to address the specifics here. If any of you have a relevant question, I'd be glad to answer it by e-mail.

In my own experience, and in many of the couples I've worked with, the trust and intimacy which developed as they began the journey of sharing her breasts had no equal; time, nurturing, affection, communication and gentle support are the mileposts along the way.

SocMed Corp.

Friendship is loneliness like freedom is slavery

By Rob Horning
 

We are increasingly connected in social networks and may thereby seem to have more community in our lives than in the days of suburban angst and dyadic withdrawal into the claustrophobic nuclear family.

It has opened a whole new space in which people can construct identity, replacing what was lost as the workplace became deadening.

So it seems that the wage relation may no longer define people, and not only because fewer of them are drawing wages. It used to be that what compelled work was the threat of starvation.

Now it is “compelled” as immaterial labor, by the promise of being someone and earning social recognition on terms favorable to the existing social order. The surplus generated by human cooperation can be harvested online without people even realizing they are working.

That is, social life can become a covert job regardless of whether or not people think they are employed or getting a wage.

They just need to be maintaining their friendships and their creativity online — escaping the alienation and isolation brought on by suburbia, by meaningless work, by anomie and loneliness.

Work once provided a culture and a sense of belonging, an identity derived not only from the skills required but from the social rituals enacted on the proverbial shop floor and the cooperation and collaboration that takes place there and after hours.

These social bonds are the ultimate source of the “general intellect” from which social value ultimately springs.

Workplace solidarity offered a potential source of resistance to administered consumerism — which itself is an appealing meme to consume:

From the ideal of workplace cooperation stems the sentimental, nostalgic representations of lost working-class culture, as well as the tropes of contemporary workplace-based sitcoms, which offer a fantasia where the only work that takes place is the elaboration of each employee’s personality.

But the production of identity, though it relies on an audience, is no longer a collaborative project undertaken at work. Suburbanization and commuting have all worked to destroy work-life integrity — often under the ironic banner of convenience.

The transformation was fairly complete in the United States by the end of the Reagan–Bush era

The classic model of contemporary mass society is provided by the suburban or exurban location of industrial and commercial working spaces. The horizontal patterns of home construction produce low density living arrangements.

Hence the nuclear family, the shopping center, the mass media constitute the nexus of social relationships that often effectively countervail the collective tasks performed at the workplace.

This sounds a lot like what I grew up with in a 1980s exurb. Work was regarded as a drag, identity hinged on what you could get at the mall (by far the most significant and most anticipated destination in everyday life).

The overriding problem was to find ways to connect meaningfully with peers and to escape the sense of being marooned with family in a detached, isolated house.

In a sense, such feelings of disconnected isolation manifest one of the vintage contradictions of capitalism: the tension between the need to commodify labor yet still capitalize on labor cooperation in the workplace.

By streamlining work processes in order to deskill them, workers themselves began to become superfluous, and work deadening. But capital needs to extract the surplus value workers produce when they collaborate.

They can’t be demoralized to the point where they become unprofitable. This capitalistic dead-end loomed in the 20th century as “Fordist” industrialism no longer could cohere.

A delicate balance, then, must be struck between making work suck for workers (to keep it unfulfilling and alienating for them so they remain willing to sell off their labor power cheaply and seek life satisfaction in consumerism), but at the same time making being with one’s fellow workers seem fun (so we will inadvertently create value through our collaborative relations with them).

And yet we mustn’t get so cozy with co-workers as to start figuring out we could be productive without bosses — especially since the “means of production” for postindustrial work can be no more expensive than a laptop and an internet connection.

Who's the boss?: social networks' new paradigm of "play-bor"

The advent of networked sociality offers a new way for capitalism to strike the balance. Enthusiasts for online culture often present it as though it offers a solution to the problems of atomization and the “crisis in leisure.”

People no longer have the sense that they live in a world in which friendship and community-making have become as rare talents as good cabinet-making.

Instead we are increasingly connected in social networks and may thereby seem to have more community in our lives than in the days of suburban angst and dyadic withdrawal into the claustrophobic nuclear family.

It has opened a whole new space in which people can construct identity, replacing what was lost as the workplace became deadening.

So it seems that the wage relation may no longer define people, and not only because fewer of them are drawing wages. It used to be that what compelled work was the threat of starvation.

Now it is “compelled” as immaterial labor, by the promise of being someone and earning social recognition on terms favorable to the existing social order. The surplus generated by human cooperation can be harvested online without people even realizing they are working.

That is, social life can become a covert job regardless of whether or not people think they are employed or getting a wage.

They just need to be maintaining their friendships and their creativity online — escaping the alienation and isolation brought on by suburbia, by meaningless work, by anomie and loneliness.

These same ideas also emerged earlier, in the workplace, to complement the shift to a postindustrial service economy. The product manufactured, more often than not, is affect — emotions, pleasures, the other side of the coin of domination. Maurizio Lazzarato, in Towards an Inquiry into Immaterial Labor details this shift in broad terms.

Immaterial labor — “audiovisual production, advertising, fashion, the production of software, photography, cultural activities, etc.” — makes apparent consumption into a form of production. It “gives form and materializes needs, images, the tastes of consumers, and these products become in their turn powerful producers of needs, of images and of tastes.”

Work becomes a matter of creating an environment in which these things can flow.

To that end, management encourages communication and networking within the workplace, which would seem like a good thing if it weren’t merely a higher form of compulsion:

The management watchword “you are to be subjects of communication” risks becoming even more totalitarian than the rigid division between conception and execution, because the capitalist would seek to involve the very subjectivity and will of the worker within the production of value.

He would want command to arise from the subject himself, and from the communicative process : the worker controls himself and makes himself responsible within his team without intervention by the foreman, whose role would be redefined as a role of an animator.

What this phase of transformation still succeeds in hiding is that the individual and collective interests of the workers and those of the company are not one and the same.

Web 2.0, likewise, is not a solution to the atomization problem but is instead its apotheosis, the social factory. Its space is preformatted, proscribing autonomous spontaneity.

People can only express their being as media — as digitized, quantifiable expression. It makes life pursuits into odd jobs of consumerism — shaping a fashion trend here, hyping a band there, making connections between disparate products, orchestrating synergies.

Online sociality materializes the notion that people are no more than a series of signifiers articulated serially, in prescribed, administered commercial spaces.

That they are nothing more than their latest status update, and whatever response this managed to generate. Selfhood has become a broadcasting project, not the holistic, lived experience one might wish it to be.

Once, the struggle was to articulate a real, authentic-seeming identity within a work world dictated by the needs of capital. It was a matter of “not selling out” even though one sold his labor power in a way which perpetuated the system.

Now, the problem is different. Before workers developed identity and a sustaining culture in opposition to management, subverting the workplace by ingraining within it a kind of resistance, a conspiracy against capital that played out as the preservation of one’s own personal aims.

But in the new system of immaterial labor, social networking and the pseudo-employment of public self-fashioning, making one’s identity is part of the production process that is subsumed under capital.

It proceeds within commercial spaces, to suit the mutual ends private citizens share with businesses. Their respective brands become co-extensive.