Ask the Midwife: What kinds of preparations can I take for breastfeeding while I’m still pregnant?

doppler small“What kinds of preparations can I take for breastfeeding while I’m still pregnant?”

Congratulations on your plan to breastfeed your child! This will probably be one of your most special times spent with your newborn/toddler but sometimes it could be a very challenging commitment.

There are many things you could do while you are pregnant to help you prepare for some of the obstacles that might confront you in the months/years ahead.

Initially, think about your philosophy of breastfeeding and what it means to you (the importance of human contract, benefits of breast milk, health benefits to mother and baby). Perhaps write these down to help renew your commitment any time you experience doubt.

Knowledge is extremely helpful for success. Learn as much as possible about breastfeeding before childbirth. There are numerous, up-to-date books, online sites, and classes that discuss the benefits, processes, and pitfalls of breastfeeding. Classes are offered at most hospitals, birth centers, WIC offices, as well as provider officers (OB, pediatrics, family medicine, and midwifery).

Stores that sell and rent breast pumps and other breastfeeding supplies and La Leche League meetings also offer classes and welcome women who are currently pregnant. Ideally, the class should be led by an IBCLC, fully knowledgeable with accurate, evidenced-based, and experienced information.

If unable to attend a class prior to your birth, purchasing a reference book is a great idea. Books such as The Womanly Art of Breastfeeding from the La Leche League, or Breastfeeding Made Simple, (Mohrbacher and Kendall-Tackett) are just two great resources.

It is always helpful to review knowledge when given sometimes conflicting instructions by various individuals after birth. These resources can help prepare you ahead of time for issues regarding nipple care, milk supply, and other challenges to breastfeeding that may occur related to your birth experience and your newborn status after the birth.

“Get to know your breasts” – have a discussion with your provider if you have any concerns about flat or inverted nipples. These are usually normal variants, but a discussion at your physical exam can help identify any potential issues.

It is extremely helpful to develop your support and information network prior to your birth. Share knowledge with your partner; look into a lactation consultant nearby (either in your place of birth or in the community); investigate postpartum doulas and support groups in your neighborhood – your OB provider and pediatrician may have some resources for you.

You should plan for birth with as few interventions as possible. Advocate for uninterrupted skin-to-skin contact with your baby immediately after birth to encourage your baby to nurse. Investigate ahead of time if this can be requested at your place of birth even if you have a cesarean section.

If your baby is handed to you swaddled in a blanket, remove the blanket. Request all initial newborn procedures be done while the baby is still on your abdomen (or request these procedures be delayed as long as possible). Request no artificial nipples during your hospital stay.

Request rooming in so you get to learn your baby’s needs and learn to read his/her feeding cues. These items may need to be discussed with your provider during the prenatal period to ensure your desires can be met at the site you’ve chosen to deliver.

Keep in mind there will be good days and more challenging days. Your support systems, knowledge base, and most of all your infant will help you get through the tough times and enjoy the experience for a long time to come.

I’d like to thank Dr. Susan Rothenberg, MD, FACOG, IBCLC from Mount Sinai Beth Israel for sharing resources and thoughts to help me write this blog.

Rochelle Lipshutz, CNM is a practicing midwife with 30 years of experience. She is currently the Director of Midwifery at the Mount Sinai Health Care System and continues to practice full-scope midwifery care.

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