As with everything before childbirth, learning what to expect and making breastfeeding plans before your little one arrives, will alleviate your worries or fears especially if this is your first baby. There is so much breastfeeding information and lactation support available for you through not only your medical care team and lactation consultants, but your family, friends, and community support groups for moms and specifically breastfeeding moms. Your breastfeeding journey may be assisted and supported by many caring folks who want only the best for you!
Your decisions about medical care in your choices of obstetrician, hospital, and baby’s pediatrician will make a significant impact on your breastfeeding experience. Choosing a hospital and doctors who support breastfeeding is key. Hospitals and birthing facilities that are designated as Baby-Friendly, implement the Ten Steps to Successful Breastfeeding, which was introduced by the World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) in 1991 and was revised in 2018. The Ten Steps to Successful Breastfeeding consist of evidence-based practices to protect, promote, and support breastfeeding in facilities that provide maternity and newborn services. WHO has called upon all facilities worldwide who provide maternity and newborn services, to implement the Ten Steps.
For additional information on the Baby-Friendly Hospital Initiative and the Ten Steps to Successful Breastfeeding, check out these links:
Baby-Friendly USA – 10 Steps & International Code
Baby-Friendly Hospital Initiative | UNICEF
Getting good prenatal care through your obstetrician is important for your health and your baby. Communicating with your obstetrician before baby arrives, about your concerns about delivery, postpartum, and breastfeeding your baby will help allay any worries or fears you may have. Talk to your doctor about your desire to breastfeed and discuss any topics that concern you that may impact lactation, such as possible induction, or use of pain medications. Harvesting colostrum is one topic that has become popular recently through social media, and if you’re interested in doing this, I definitely recommend you discuss this with your obstetrician before making a decision. Hand expressing your breasts for colostrum during the last few weeks of pregnancy, a.k.a. antenatal colostrum expression is not new, and studies have been conducted among mothers with healthy or low risk pregnancies, especially diabetic mothers who want to help stabilize their babies’ blood glucose after birth. The results from this research and protocol for antenatal colostrum expression are mixed. Harvesting colostrum is not necessary for every mom, especially mothers at high risk of pre-term deliveries, so talk to your doctor for advisement. Moreover, breast/nipple stimulation from antenatal colostrum expression before 37 weeks gestation or use of a breast pump may stimulate pre-mature labor and is not generally recommended.
Preparing for delivery and breastfeeding by taking a Childbirth Class and Breastfeeding Class are always helpful. Find a Childbirth Class that focuses on a more natural approach that encourages a minimal intervention birth, and teaches natural coping techniques to handle labor pain. As for a Breastfeeding Class, find one that goes beyond basic breastfeeding information. A Breastfeeding Class that reviews the local hospitals’ protocol for breastfeeding moms, gives you opportunity to view a few breastfeeding videos, teaches you how to hand express and do breast compressions, discusses pumping, teaches the paced-bottle feeding technique, and reviews breastfeeding tools and accessories, such as supplemental nursing systems and nursing bras, would be most helpful.
If unable to find a Breastfeeding Class that includes all this information, you may want to schedule a pre-natal appointment with a Lactation Consultant (IBCLC) to talk about these topics or anything else you may have questions about. Moreover, talk to family and friends who have breastfed, to provide suggestions and answer any of your questions. Another support resource to consider is joining your peers in a breastfeeding support group like La Leche League, Breastfeeding Cafe, or your local community breastfeeding or mothers’ group. While each mom may have a different breastfeeding experience and all suggestions may not necessarily work for every mom, talking through recommendations is helpful in providing information to you. You may then do further research to learn more, if needed.
Selecting a pediatrician who is knowledgeable about lactation and will be good support for you throughout your breastfeeding journey is key as well. Ask family and friends for recommendations of local breastfeeding-friendly pediatricians. Interview those pediatricians who you are interested in taking care of baby and support your breastfeeding. Some clinics may have a lactation consultant (IBCLC) on staff who is available to patients for breastfeeding assistance and support.
Breastfeeding assistance and support may come from dad too! Be sure to encourage and include your partner in your breastfeeding journey. Dad may take the Childbirth and Breastfeeding Classes with you and may also help advocate for you in L & D and breastfeeding.
Check out our blog for dads at this link:
9 Ways Dad Can Help with Breastfeeding – All Things Breastfeeding Momma & Babe
Above all, advocate for yourself in your decision to breastfeed your baby who is soon to arrive. Learn as much as you can to prepare yourself for the special delivery event, and seek out those who can help you reach your goals. Talk to your obstetrician in advance of delivery to let him know your breastfeeding plans. Discuss your goal to keep interventions at a minimum as possible during labor and delivery, so that breastfeeding may succeed.
When time comes to have baby, and you have been admitted to the hospital, be sure to also let your nurses know your goals to keep interventions at a minimum during labor and delivery and your plans to breastfeed baby. Holding your baby skin to skin right after delivery and as much as possible during your hospital stay, is highly encouraged to arouse baby and enhance breastfeeding. Hand expression of your breasts in early postpartum is also highly encouraged to collect colostrum to feed baby, especially if your little one is having difficulty latching or initially too sleepy to breastfeed. Continue holding baby skin to skin, and hand express for at least 15 minutes on each breast, every 2-3 hours. Feed collected colostrum every 2-3 hours, until baby awakens and breastfeeds. If you and baby must be separated due to medical complications, ask your medical care team to help you start pumping with a hospital-grade breast pump; pump both breasts at the same time for 15-20 minutes, every 2-3 hours. If you and baby have no medical problems, rooming-in with baby (keeping baby with you in your room) will give you the opportunity to observe and learn baby’s hunger cues and breastfeed baby on demand. Frequent breast stimulation and draining of the breasts at least 8 times per 24 hours is essential in establishing and maintaining milk production. Be sure to ask for breastfeeding assistance as needed, from the nurses and lactation staff at the hospital. If the hospital is Baby-Friendly or Ten Step designated, the medical staff is specially trained to assist and support breastfeeding couplets. With this breastfeeding support, and an early start on breastfeeding and/or pumping, your milk supply increases more quickly, and your breastfeeding is off to a good beginning.
Check out Lactation Education Resources for detailed instructions with photos about hand expression: handouts-parents (lactationtraining.com)
Also here’s a video from Stanford Medicine to watch the technique of hand expression: Hand Expressing Milk | Newborn Nursery | Stanford Medicine
Breastfeeding Videos – International BreastFeeding Centre
Here’s another video from IABLE (Institute for Advancement of Breastfeeding & Lactation Education) about the paced bottle feeding technique: Bing Videos
These are some recommended breastfeeding and parenting books, and research articles on antenatal colostrum expression to check out for more information and references:
“Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers” by Nancy Mohrbacher and Kathleen Kendall Tackett: https://amzn.to/3z0s6Fn
“Ina May’s Guide to Breastfeeding: From the Nation’s Leading Midwife” by Ina May Gaskin: https://amzn.to/3yOHtAJ
“The Womanly Art of Breastfeeding: 8th Edition” by Diane Wiessinger, Diana West, and Teresa Pitman: https://amzn.to/3VhBH2k
“Your Baby Skin to Skin: Learn to Trust Your Baby’s Instincts in the First Year” by Rachel Fitz-Desorgher: https://amzn.to/4e66bNc
“Heads Up Mom: The Early Years with Baby and Toddler” by Lori Arnold: https://amzn.to/3z11eoJ
“LATCH: A Handbook for Breastfeeding with Confidence at Every Stage” by Robin Kaplan, M.Ed., IBCLC: https://amzn.to/4aVm06w
“Three in a Bed: The Benefits of Sleeping with Your Baby” by Deborah Jackson: https://amzn.to/3yQ76Bt
“Sleeping with your Baby: A Parent’s Guide to Cosleeping” by James J. McKenna: https://amzn.to/3VyUMhG
“Nurturing Wellness and Joy from Bump to Birth: A Guide to Care and Wellness Through Pregnancy” by Amber Reese: https://amzn.to/3Vdcs0V
“Mayo Clinic Guide to Your Baby’s First Years, 2nd Edition” by Walter Cook, MD and Kelsey Klaas, MD: https://amzn.to/3Ri2Tg6
“Your Baby’s Microbiome: The Critical Role of Vaginal Birth and Breastfeeding for Lifelong Health” by Toni Harman and Alex Wakeford: https://amzn.to/3V9DAho
The video “The Magical Hour: Holding Your Baby Skin to Skin in the First Hour After Birth” produced by Dr. Brimdyr, Dr. Widstrom, and Kristin Svensson is a good resource as well: https://amzn.to/4c8o9wP
Human Milk Oligosaccharides in Antenatal Colostrum: A Case Study – PubMed
A brief history of antenatal colostrum expression, and where to from here – PubMed
A brief history of antenatal colostrum expression, and where to from here | Proceedings of the Nutrition Society | Cambridge Core
Online Video Instruction on Hand Expression of Colostrum in Pregnancy is an Effective Educational Tool – PubMed
Collecting Colostrum: What Lactation Consultants Want You to Know | University of Utah Health