Preparing for Breastfeeding Success: Tips for Expectant Moms

Many expectant moms assume that breastfeeding is an easy and natural part of motherhood and they will be able to breastfeed as long as they want. In some cases, physical challenges can make nursing difficult or impossible, and some women may choose not to nurse.

But, for those who want to nurse, unexpected, and sometimes unnecessary, hurdles can get in the way of breastfeeding successfully. From your choice of doctors and hospital, to whom you surround yourself with after your child’s birth, here are some tips for how you can maximize your chances of breastfeeding success.

Take a breastfeeding class at your local hospital or a local maternity education center to learn the basics of breastfeeding. While there is no way to “practice” breastfeeding or to really prepare for the experience, understanding as much as you can about how it works, problems that can occur, and how to handle them can help better prepare you for whatever comes your way.

Ask a pediatrician if they support breastfeeding and you are likely to get a resounding, “Yes.” So, how can you tell if your pediatrician truly engages in practices that support breastfeeding?

• Find out which Lactation Consultant they refer to and then learn what you can about her.

• Ask questions to determine their attitude towards breastfeeding. How would they compare breastfeeding to bottle-feeding? Under what circumstances would they recommend supplementation? How do they handle slow weight gain or jaundice? Does their office routinely give information about formula or formula samples to new moms? Do they believe infants should be fed on a schedule?

These articles provides excellent in-depth discussion of questions to ask a pediatrician with regard to breastfeeding and how to know whether the doctor is truly pro-breastfeeding.

• Choosing a Pro-Nursing Doctor for Your Baby
• How to Know a Healthcare Practitioner is not Supportive of Breastfeeding

“Baby-friendly” hospitals engage in practices that promote breastfeeding. These include:

• having a breastfeeding policy that is communicated to staff
• informing mothers about the benefits of breastfeeding
• helping mothers initiate breastfeeding within half an hour of birth
• showing mothers how to breastfeed and maintain lactation
• not providing any food, drink, or pacifiers to the newborn
• encouraging breastfeeding on demand
• allowing mothers and infants to “room in” together 24 hours per day
• establishing breastfeeding support groups for new mothers.

While a paltry 4% of US hospitals engage in all or most of these practices, asking questions about your hospital’s policies can help you advocate for yourself when you give birth.

Click here for a map of baby-friendly hospitals in the US.

A birthplan is a clear statement, written by you, that describes your preferences and desires during your birth. Whether you give birth naturally, with medications, or via c-section, certain practices in the hospital can increase or decrease the chances of breastfeeding success. Here are the elements that have been shown to improve breastfeeding success:

• Breastfeeding should occur within 30 minutes of birth
• The baby should not receive any food or drink, other than breastmilk
• The baby should not be given a pacifier or artificial nipple of any kind
• The baby should remain with the mother at all times, 24 hours per day
• The baby should nurse on demand

• The mother should meet with a lactation consultant as soon as possible and as frequently as needed

While most hospitals have lactation consultants on staff and even offer breastfeeding “classes” for new moms, the quality and training of these staff may differ, even within the same maternity ward. Find out about the lactation consultants at your hospital by asking other moms who have recently given birth about their experience. If you don’t know any new moms, find out if there is a yahoo group or other online network of moms in your town. La Leche League members in your area might have opinions and advice to share.

When you’re in the hospital, request to meet with the recommended lactation consultant. Even if things seem to be fine, a trained professional can give you useful feedback, advice, and encouragement.

Although you hopefully won’t need to see a lactation consultant after you leave the hospital, if the need arises, having the names and numbers of the ones you’d like to work with on hand will be very helpful. You may not have the time or energy to do this research once your baby is born and you are in critical need. Again, ask other moms in your area for recommendations.

Some pediatricians are more quick than others to suggest supplementation or weaning of your child if things aren’t going exactly to schedule. Slow weight gain or jaundice may worry your doctor into suggesting supplementation. If this happens, make your intentions around breastfeeding clear. Ask how serious they think the weight gain, jaundice, or other problem is and whether it is possible to wait another day or two to see if the breastfeeding situation improves. Ask to see a lactation consultant, and insist on one that you are comfortable with.

Having a supportive network of friends and family can be one of the most influential factors on breastfeeding success. Being clear about your intention to breastfeed and educating those around you about how important it is to you and how they can help can help pave the way for support. In addition, most places now offer breastfeeding support groups through hospitals or your local La Leche League. Online groups can also provide support.

Your health insurance company may cover some of the expenses related to breastfeeding, such as lactation services, pump rental, or the purchase of other breastfeeding supports, such as supplemental nursing systems or nipple shields. Call your insurance company or look online to figure out the process for getting reimbursed. You may need to write a “grievance” letter to explain why these costs were medically necessary and why you should be reimbursed.

Some insurance companies will cover the cost of a breastpump, especially if you have a prescription from your doctor. Before buying a pump, call your insurance company to see if the cover breastpumps, and then ask your doctor to write a prescription.

A common reason for stopping breastfeeding or supplementing with formula is an actual or perceived low milk supply. Concern about slow weight gain may cause women to throw in the towel. However, if your supply is truly low, there are many methods for increasing milk supply if the basics are not working (including nursing on demand, drinking lots of water, and getting rest). Herbs, such as fenugreek and blessed thistle, have been shown to increase supply. These can be found at Whole Foods or other speciality food stores. In addition, while it is not approved by the FDA for this use, domperidone (a medication used to suppress nausea and vomiting) increases milk supply. While only a handful of pharmacies distribute domperidone in the United States, it can also be ordered online at a reasonable cost.

One of the biggest factors in determining a woman’s ability to breastfeed long-term is whether or not she returns to work. Many mothers continue to nurse successfully even after returning to work full-time by pumping and storing their breastmilk. Extending your maternity leave by using vacation time or asking for a flexible work schedule when returning to the office can help improve your chances of nursing longer term.