Don’t Forget to Get Breastfeeding Ready, too!
Written by: Karen Miles, IBCLC
Clinically reviewed by: Laura Serke, RD, CSPCC, LD, IBCLC
As a lactation professional, I have often heard the phrase: “I wish I had known that before having my baby!” The range of baby-related topics to learn about postpartum, when immersed in all things baby, can feel overwhelming. Learning as much as you can beforehand about one important research topic, breastfeeding, will help you feel more prepared postpartum. After the delivery you may be smitten by your sweet baby, but also drained from little sleep. That sleep deprivation can make learning new things, like breastfeeding, more difficult.
Another incentive to start learning early? Educating yourself about lactation while pregnant may result in better breastfeeding outcomes. According to the Academy of Breastfeeding Medicine (ABM), which sets healthcare provider standards for breastfeeding care in the United States,
“Evidence from multiple systematic reviews demonstrates that women who receive prenatal education about breastfeeding have higher rates of breastfeeding initiation, breastfeed for longer, and are more likely to exclusively breastfeed, particularly when prenatal education is provided in conjunction with postpartum support” (ABM Protocol #19). [emphasis added]
Tapping into some recommendations in that protocol, as well as my own personal observations as a lactation professional, here are ten ways to get ready while pregnant to breastfeed postpartum. (As an added bonus: Each tip should lessen any worries you may have, too!)
1. First, find a breastfeeding-friendly obstetrician or midwife who can:
-
discuss breastfeeding frequently (Ideally at each prenatal visit. But of course, I am partial to that!),
- explain concepts in an easy-to-understand manner,
- provide you with support that is culturally sensitive (if your provider is from a different culture than your own), and
- give care in your own language or via an interpreter
Trust is key in any relationship, especially a patient-provider one. If you find the prenatal appointments are too short to fit in all the lactation advice you would like, then ask for a referral or seek out…
- a hospital-based or private practice International Board-Certified Lactation Consultant (IBCLC). To find a private practice IBCLC near you in the U.S., search this directory: Find an IBCLC Lactation Consultant | USLCA - United States Lactation Consultant Association.
or
- a physician with advanced-level breastfeeding training – known as a Breastfeeding Medicine specialist. To find a Breastfeeding Medicine physician in your area, check out this Academy of Breastfeeding Medicine directory: Find a Physician. (If you want the physician to be an IBCLC, too, select “IBCLC” as one of the criteria.)
2. Include a partner, or a key support person, in some or all of your prenatal appointments.
Whether it be an obstetrician, midwife, doula or lactation consultant visit, having your support person there, and on board with your breastfeeding goals from the beginning, can help you not feel alone. That support person can also serve as an extra brain to you for key pieces of information such as how to breastfeed while side-lying in bed (which you may need help remembering during a future 2 a.m. feeding).
3. Discuss with your provider(s) any anatomical features or health conditions that you think could affect breastfeeding, or that may just require some little adjustments to breastfeed.
For example:
- Do you have tubular breasts, a previous breast augmentation or breast reduction? A diagnosis of diabetes, anemia, hypothyroidism, PMOS (polyendocrine metabolic ovarian syndrome, formerly "PCOS"), or insulin resistance? If yes, you may want to learn if there are ways to maximize your milk production.
(Depending on your individual situation, you may delightfully discover postpartum that you have no milk supply issue at all. Or if your supply is lower than you would like, you can try one of several ways to boost milk production – pump and/or hand-express after breastfeeding sessions, take milk-boosters called galactagogues that your provider recommends, etc. And remember, breastfeeding does not have to be all-or-nothing. You may decide to partial-breastfeed and partial-supplement if your supply is not in full.)
- Do you have flat or inverted nipples and want to learn techniques to latch your baby successfully?
(The good news is babies breastfeed, not nipple feed. Encouraging your baby to have a wide open mouth when latching is the key trick here.)
- Do you have diabetes and are eager to hand-express a little milk now at 37 weeks gestation, in case you need a little extra for your baby early postpartum, like you read about somewhere online?
(Opting to hand-express milk prenatally should only be done with your OB or midwife’s blessing, to avoid spurring on labor early. Some mothers with diabetes have a full milk supply, or if not, they may choose to pump a little early postpartum to top-off their baby’s feedings until milk comes in fully.)
- Are you on some daily medication? Or do you drink occasionally and need advice on whether you can breastfeed safely?
(Good news on most medications: Many are compatible with breastfeeding. Helpful resources for breastfeeding and medication use include Hale’s Medications & Mothers’ Milk and LactMed. And keeping alcohol use to just occasional use, and spacing it out from breastfeeding adequately, works for many families.)
- Is your baby-to-be at risk for preterm birth? Or does your baby have a known fetal anomaly, such Down syndrome and/or a congenital heart defect or GI condition, which you are told may require surgical repair? Then you may want some pumping pointers in case you are separated from your baby while your sweetie is undergoing surgery or observation. And you may want to learn some special latching techniques, like the Dancer Hold, in case your baby needs some extra support when latching.
All of these are excellent discussion points with your provider. If your provider advises that you can safely breastfeed with your health circumstances, but mentions something could pose a potential challenge with breastfeeding, ask for a referral to either an IBCLC or a Breastfeeding Medicine physician (see point #1 above for links to find one). They can help you develop a game plan for overcoming or limiting those challenges.
4. Take a breastfeeding basics class online or in-person.
You’ll feel like you’ve read a whole book on breastfeeding in likely half the time! Plus, you’ll meet other expectant parents to connect with and laugh alongside. Many hospitals offer breastfeeding classes. And your health insurance may cover any class fee. To see if your hospital or midwifery practice offers breastfeeding classes, search by the word “class” on their website.
5. Ask your provider about the impacts to your health (hello, reduced risk of breast and ovarian cancer!) and your baby’s health of breastfeeding versus not breastfeeding. Also, ask about the downside of unnecessary supplementation.
Yes, even if you already learned this from your breastfeeding class, hearing it from your provider will make it stick even more. When you are nursing around the clock in the early days postpartum, remembering the whys of breastfeeding and avoiding unnecessary supplementation can be a powerful motivator to keep going.
6. Ask your provider about the basics of breastfeeding.
For example, the physiology behind how it works, steps to latch your baby, and various positions for breastfeeding (both baby-led and parent-led methods). This discussion will solidify what you have learned in your breastfeeding class. It may feel silly, but after returning home from your healthcare appointment, consider using a doll or stuffed animal to “practice” latching and positioning along with pillows for support. Doing so will help you store in your visual memory the basics.
7. Ask your provider what to expect when it comes to breastfeeding support in the delivery setting (at the hospital, a birth center, or at home – wherever you plan to deliver) and right after delivery.
According to the Academy of Breastfeeding Medicine, rooming-in with the baby, lots of skin-to-skin time with baby, and avoiding pacifiers can help “maximize” breastfeeding success in the hospital setting. Inform your provider of your wishes, and advocate for yourself and your little one where possible.
8. If you plan to use a personal-use breast pump…
Find out which pump, and related products like breast milk storage bags, your health insurance will provide. Also, find out when you can tap into those insurance benefits (...during your last trimester of pregnancy, perhaps, or only after delivery?). To discover those details, check out Aeroflow’s insurance eligibility tool and/or contact your health insurance company using the phone number on your insurance card.
Then, decide if you want a pump backup, for peace of mind if there is a delay getting a pump through insurance. Or, so that you can keep one pump at work/your car, and one at home. If you feel two pumps would make life easier, add a different pump to your gift registry or purchase it.
(Note: If given the choice of just one personal use pump, for most parents a new, double-electric, plug-in-the-wall pump is generally going to have the best breast milk output for time spent at the pump.)
Then, familiarize yourself with:
-
each pump's features and tutorials found on the pump manufacturer's website, to shorten your learning curve postpartum. (But hold off on doing any actual pumping until you are postpartum.)
-
the CDC's breast milk storage guidelines, to inform you how to safely store breast milk for your baby in your refrigerator and freezer without the milk spoiling. For quick reference, print and post the guidelines to your fridge.
-
the CDC's pumping hygiene guidelines for getting pump parts clean after each use and sterilized daily. This will help you prevent bacterial contamination in the precious breast milk you pump and feed to your baby.
- the steps to hand expression of breast milk, as an add-on to the end of a pumping session, or as an add-on to breastfeeding. This will help you collect even more milk postpartum if more milk is needed. To learn how to hand express milk, go to firstdroplets.com, click on “downloads” at the top, and then click on #5 - “Hand Expression.”
(Be sure to get clearance from your healthcare provider first if considering collecting any milk through hand expression while pregnant. But having a general visual idea of the steps to hand expression now will make it feel less foreign postpartum.)
Special note: Is one of your future goals donating any extra breast milk to help medically fragile babies whose families need some support?
Then it wouldn’t hurt to locate a human milk bank near you now. Check out their donation guidelines that are specific to breast milk storage, pump parts cleaning, and sterilization requirements. The reason? Some milk banks’ storage and cleaning guidelines may exceed the CDC’s guidelines. But wait to start the milk donation screening process until you are well on your nursing journey, and are certain you have a surplus of milk that is beyond any return-to-work or other needs.
9. Feeling anxious about breastfeeding, or need a little mental health support? Ask your provider for a mental health referral.
If you want to breastfeed postpartum but are experiencing depression, anxiety, post-traumatic stress disorder from a troubling past, or another mental health condition, get professional help now. Then, you can feel more empowered to head into postpartum life with your baby with joy.
You may also feel less anxious about breastfeeding by watching videos of people from real-life breastfeeding successfully. Imagine yourself doing the same. To watch some, go to globalhealthmedia.org. Click on “Our Videos” at the top. Then, in the “Enter Keyword” box, type “breastfeeding” to search for breastfeeding videos. One nice perk to this website: If English is your second language, many of the videos allow you to change the language to another language when performing the search.
10. Check out a breastfeeding support group while pregnant.
Whether community-based and breastfeeding peer counselor-led (hello, nonprofit breastfeeding peer support organizations and WIC offices), or hospital-based and led by an IBCLC lactation consultant, either is beneficial. Seeing other parents breastfeed, and hearing their stories of overcoming challenges, can do a world of good by boosting your confidence.
And if your state offers prenatal and postnatal home visitation programs by a visiting nurse or a community health worker, sign up to take advantage of those as well. The more equipped and supported you feel, the more your breastfeeding confidence will soar.
Karen Miles is an International Board Certified Lactation Consultant (IBCLC) and Lactation Content Specialist with Milkify.
Laura Serke is a Registered Dietitian and an International Board Certified Lactation Consultant (IBCLC) with Milkify.
This article is for informational purposes only and is not intended to diagnose, treat, or be a substitute for medical advice. Please consult your healthcare provider for any questions you may have related to your own health circumstances.
