Birth Issues Journal > Reviews

DR JACK NEWMAN'S GUIDE TO BREASTFEEDING*
Jack Newman and Teresa Pitman

Review by Virginia Thorley

Jack Newman's book presents a positive, forthright tone, with concrete advice on how to make breastfeeding work for most women. The introduction provides a personal account of how he, a male Canadian paediatrician and father, with little training in breastfeeding, became interested in this field, developed expertise and has operated hospital breastfeeding clinics from 1984.

The text reinforces key points through case histories, in which authorial comments on incorrect advice are inserted in brackets. Sidebars (boxes) are used for short quotations from other sources, and occasionally for advice summaries.

The chapter titles are: The Normal Way to feed a baby, an Ounce of Prevention, Common Problems and Solutions, and You and Your Breastfed Baby. Newman has a memorable turn of phrase, pitched to make the reader think and he and his co-author use repetition of key points. Throughout the text, Newman emphasises that if the baby isn't drinking, he isn't feeding. This is how he takes issue with the topical issue of 'dehydration in breastfed babies', a term which he insists is incorrect:

If the baby had been breastfeeding, he would not have been dehydrated. The problem is that the baby is not feeding at all. The baby may appear to be taking the breast, but he isn't. (p90)

Like others before him, notably Marsha Walker, in her two monographs on the hazards of not breastfeeding, Newman takes up the issue of not thinking of breastfeeding as providing some add-on advantages, but as a benchmark, so that alternative methods of feeding are less than optimal (p9-12). In case health professionals and friends are reluctant to raise these issues for fear of creating guilt in mothers who artificially feed, Newman addresses the issue of guilt in two quite similar sections in the text (p15-16,35-37). For instance, Newman questions health professionals who are comfortable applying pressure to ensure parents have a safety capsule fitted in the car before taking the baby home, or who actively discourage pregnant women from smoking or drinking alcohol - behaviours which have health risks - but at the same time, do not consider it important for mothers to breastfeed their babies, despite considerable evidence to the contrary.

Newman discusses the use and misuse of weight measurements, what growth charts are intended to do and what percentiles mean.

Lethargic babies who are at the breast but not actually breastfeeding will not, Newman asserts, benefit from more frequent feedings. He writes: 'eight times nothing is nothing, just as six times nothing is nothing', for which the remedy is 'to fix the breastfeeding technique and get food into the baby' (p64). He goes on to describe markers of breastmilk insufficiency and how to improve the breastfeeding and milk transfer.

Newman is known as a proponent of the breast compression technique, to restart the flow of milk and keep the baby interested after the feed slows down, in order to get more milk into the baby. Instructions, with an illustration, are on p70-71, and these are repeated later in the text (p141-143). He advocates that the mother adapts the technique, using what works for her.

Reiterating that the baby learns breastfeeding by breastfeeding, Newman expands on this idea:

Babies learn to breastfeed by breastfeeding; babies do not learn to breastfeed by cup-feeding, finger-feeding or any other feeding. Babies can learn to bring their tongues forward by cup feeding; they can be stimulated to suck in a manner similar to what they would normally do on the breast with finger-feeding; but babies learn to breastfeed by breastfeeding. Strange as it may seem, there are many who don't understand this. (p82)

The black and white photographs include some helpful ones illustrating latch, including some shots of babies coming in to latch from under their mothers' heavy breasts so that they are chin-to-breast (p55-56). These provide a point of reference with a photo (p50 number 3) of a baby whose head is too high above the nipple.

A limited list of resources, and mainly Canadian, are provided in the back of the book. However, Newman mentions three websites, one his own, that are obviously easily accessible and full of useful information. There is no bibliography, but this book is not intended as an academic or scholarly text. The index is comprehensive and user-friendly.

This book is recommended reading for mothers, as the target audience is primarily the consumer. Nevertheless, its focus on workable clinical techniques also makes it useful for those who work with pregnant women and breastfeeding mothers, including childbirth educators, midwives, lactation consultants, child health nurses and breastfeeding counsellors. Those who know Newman as 'Doctor Jack' on Lactnet (an internet lactation discussion list) will particularly welcome this text. Although written for North American readers, it is very suitable for the Australian market.

Virginia Thorley OAM MA IBCLC
Author, breastfeeding counsellor.
Brisbane.

* Published as The Ultimate Breastfeeding Book of Answers in the United States.