Ellen Mateer, United Kingdom
Dr. Michel Odent’s recent webinar for LLLI was built around the question of whether colostrum is vital. The introduction he gave for the website to advertise the webinar is as follows:
“It is now well known that human colostrum is beneficial and even precious. It is also well known that lactation is supposed to start during the hour following birth. In a renewed scientific context, the time has come to turn focus to questions regarding birth environment from a bacteriological perspective. From that perspective, there has been a real revolution in less than a century. The programming of the immune system is at stake.”
This webinar provided a fascinating and informative glimpse into different perspectives of the birth-breastfeeding continuum. It began by explaining that among most mammals early colostrum is “strictly speaking—vital,” giving the example that if a calf has no access to colostrum it will not survive. He went on to say that it’s different for humans: “for thousands of years, perinatal beliefs and rituals have deprived human neonates of early colostrum” and yet our species has survived.
Colostrum is not vital
Dr. Odent recalls his own experience in 1953 working for six months as a medical student in a maternity unit of a Paris hospital. At this hospital, babies were put in the nursery, with no access to early colostrum, and access to the breast only after two-three days. It was simply believed that the colostrum was not good for the baby.
Dr. Odent gave some more examples from different times and cultures. Since the beginning of the socialisation of childbirth, several thousand years ago, most cultures have passed down a great diversity of beliefs and rituals from generation to generation—always with the same result: “to postpone the initiation of lactation, and to deprive the human baby of early colostrum.”
Dr. Odent stated: “human colostrum is not vital.” This will seem a controversial statement to us as Leaders. In explanation, Dr. Odent referred us to the specific structure of the human placenta. Between the maternal and fetal bloodstreams there is a thin membrane with receptors which effectively transfer antibodies to the bloodstream of the fetus. The result is that at 38 weeks gestation, the baby has roughly the same antibodies as the mother, and this explains the big difference between humans and most other mammals in the perinatal period.
The human baby
For most other mammals, the main preoccupation in the period immediately following birth is fast access to colostrum, thereby introducing antibodies into the newborn’s body. Among humans it’s different: bacteria familiar and friendly to the mother are also familiar and friendly to the baby. A human baby’s immune system starts to be programmed immediately after birth. In the past there was a great diversity of familiar and friendly bacteria in the places women gave birth. Today it’s the opposite with most babies born in hospital—the bacterial environment is not familiar and it lacks diversity putting the programming of the immune system at risk.
Dr. Odent proposes that we try to compensate for this micro-deprivation at birth. Our cultural conditioning tells us microbes are the enemies, and often babies have been “protected” from microbes on their mother!
In 1977 Michel Odent published papers stating breastfeeding should start in the hour following birth. La Leche League has long known the importance of early initiation of breastfeeding. We know the human baby can reach the breast in the hour after birth; we understand human colostrum is beneficial and even precious, but still human babies are deprived of it. The main reason now is that the continuum of birth and the initiation of lactation is disturbed because birth is more difficult.
There are now two kinds of birth: birth at home, and birth elsewhere. Most women give birth “elsewhere.” Odent says we have new reasons to demarginalise home birth and make it safer. In most countries home birth is not easily accessible or culturally acceptable, and for that reason it’s more dangerous
Dr. Odent urges that it is crucial that we reconsider completely our understanding of birth’s physiology. Until now most scientists have asked why human birth is more difficult than for other mammals. And in general their answers were about morphology (form and structure) and mechanics—the size and shape of baby’s head. Dr. Odent wants us to consider another question—how do we explain that some women can give birth very easily, when morphologically and medically speaking their situation is not special?
In some situations our neocortex (a part of the brain) can obscure and make some physiological functions more difficult. It is this neocorticol response that makes socialised birth difficult. Nature gave us a solution to make human birth possible and sometimes easy, but a woman giving birth needs to reduce neocorticol activity. Even after thousands of years of socialised birth, some people still understand this; some midwives, doulas, birth workers know that a birthing woman needs to behave in a way often considered unacceptable—shouting, sweating, not responding to others, and finding positions that work for them.
Birth workers don’t need to *help* a woman in labour, nor control the birth process. The role of the midwife is to be the protector of a labouring woman against all stimuli of the neocoretx . Dr. Odent says language is the main enemy, and that bright light in the birthing area, attention from staff, and feeling observed also have a detrimental effect on the birth process.
Dr. Odent would like us to reconsider and change our language, from a focus on other individuals who coach, manage, help, and support to a focus on the mother and baby. This will help with the aim of disturbing the birth process as little as possible.
It is well known today that nothing can replace human milk, however, knowing this doesn’t always help babies to get early colostrum. If we focus on disturbing the birth process as little as possible, breastfeeding, including access to early colostrum, will follow. La Leche League philosophy recognises this: “Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.”
Dr. Odent summarises that to humans:
“Early colostrum is not strictly speaking vital, babies can survive without colostrum BUT we must say—today, when most women give birth in an unfamiliar bacterial environment, the early colostrum, even if it’s not vital, is more precious and more valuable than ever.”
Michel Odent, MD, was in charge of the surgical unit and the maternity unit at the Pithiviers (France) state hospital from 1962 to 1985 and is the founder of the Primal Health Research Centre (London). He is the author of the first article in the medical literature about the initiation of lactation during the hour following birth (1977), of the first article about the use of birthing pools (Lancet 1983), and of the first article applying the “Gate Control Theory of Pain” to obstetrics (1975). See pubmed.com (Odent M). He also created the Primal Health Research database www.primalhealthresearch.com and is the author of 16 books published in 24 languages. Dr. Odent has previously been a consultant to the Professional Advisory Board of LLLI. Michel Odent is Visiting Professor at the Odessa National Medical University (Ukraine) and Doctor Honoris Causa of the University of Brasilia (Brazil).
Ellen Mateer lives with her partner and three children (17,15 and 11) in West Yorkshire in the United Kingdom. She was recently elected to the LLLI Board of Directors. When she is not working for LLL, she works with an intergenerational community theatre group and enjoys time in her garden.