cristina

Cristina Toff, lactation counselor and educator (CLEC), pregnant with her 2nd boy

While breastfeeding is the biological norm, that does not mean that it always comes easily, naturally or without challenges and complications. I often find that moms just expect breastfeeding to work - and sometimes it does - but more often than not, success at breastfeeding requires preparation, practice and support - just as success at many other things does.
— Cristina Toff

When it comes to breastfeeding, two of the most common comments I receive from parents is ‘I didn’t realize it would be this difficult.’ and ‘I wish I would’ve known about this before the baby arrived.’ While breastfeeding is the biological norm, that does not mean that it always comes easily, naturally or without challenges and complications. I often find that moms just expect breastfeeding to work - and sometimes it does - but more often than not, success at breastfeeding requires preparation, practice and support - just as success at many other things does.

Research shows that prenatal breastfeeding education and preparation are key to reaching your breastfeeding goals. Below are 6 things you can do before baby arrives to help ensure breastfeeding success.  

1. Create a Birth Plan

Labor and delivery come in all different shapes and sizes and is often times unpredictable; babies come on their own time and sometimes our plans change. So with all the unpredictability, why is a birth plan important?  A birth plan allows you to think through medical decisions you may be faced with and decide what is or isn’t important to you. A birth plan also gives you the opportunity to prepare for this major transition in your life without being overwhelmed by stress, hormones or pain and communicate your desires to your support team. While you're making decisions about the type of birth you'd like to have and all of the medical decisions you'll need to make, think about working your thoughts on breastfeeding into your plan. Share your breastfeeding goals with whomever is helping to deliver your baby so that they can make the right decisions to protect your choices.

Every woman should have the choice of how her labor and delivery goes. But there is a lot of misinformation out there about how birthing works, and how birth affects breastfeeding often goes undiscussed. Interventions such as IV fluids, epidurals and inductions can result in some early breastfeeding challenges as your body processes out the extra fluids and as baby processes out any medications from labor which may make them especially sleepy or uninterested in latching on. Does that mean that they'll prevent you from breastfeeding? Absolutely not. However, it is important to understand how your birth and birth choices may impact the start of your breastfeeding journey and how to take steps that will help you overcome any obstacles that come your way.

What are some topics to include in your birth plan to ensure you get off to a good start with breastfeeding?

Skin-to-skin immediately after delivery will regulate baby’s heart beat, temperature, blood pressure and help them stay calm as they transition to life outside the womb. A calm baby is readily able to latch and being skin to skin means they’re front and center at the breast to eat and to stimulate the breast which tells your body to amp up your milk production.
— Cristina Toff
  • Minimize interventions. Research shows interventions such as epidurals, anesthesia, c-sections, IV fluids, and pain medications can cause unnecessary obstacles early on in your breastfeeding journey and influence how long you breastfeed.  We get it - birth is the furthest thing from comfortable and sometimes our delivery does not go as planned - so we recommend doing what feels right to you, finding support, setting expectations that align with your birth choices and being prepared with strategies to help in those early days to make sure you’re getting started with your best foot forward.

  • Start early. Once baby arrives there are certain steps you can take that can make breastfeeding initiation a bit easier on you and baby. Skin-to-skin immediately after delivery will regulate baby’s heart beat, temperature, blood pressure and help them stay calm as they transition to life outside the womb. A calm baby is readily able to latch and being skin to skin means they’re front and center at the breast to eat and to stimulate the breast which tells your body to amp up your milk production.

  • Delay unnecessary time away from your baby. This includes putting off things like getting baby’s weight and height, bathing baby, and minimizing passing baby around to all your visitors. This is especially important within that first hour after delivery until baby latches for the first breastfeed however, this remains important over the next few days because time at the breast allows baby to signal to your body to kick up your milk production and gives you unlimited time to practice breastfeeding.  

  • Limit visitors. Baby has just arrived and you’re ready to show them to the world! It is an exciting time but it is also a critical period of bonding time with mom and baby that sets the platform for milk supply and allows both mom and baby to practice breastfeeding. Having visitors around means we’re less likely to be doing skin to skin or nursing so enjoy some visitors but keep them to a minimum and allow yourself time to soak in those early moments with your babe.

  • Hold off on artificial nipples. Artificial nipples like pacifiers and bottles replace time at the breast, which reduces breast stimulation and interferes with baby’s ability to communicate their needs like early hunger cues. Feeding on demand helps build our milk supply and is one of the key ways to make sure baby is getting enough milk. In order to feed on demand, we need to be able to see these hunger cues. With bottles, babies can develop a preference for the faster flow from the artificial nipple so unless medically necessary, skip the bottles until your milk supply is more established. If you find that you need to express milk to feed baby in an alternative way, opt for spoon or syringe feeding which gives you more control over how much they’re getting at one time and helps them more easily transition back to breast.

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Cristina Toff, lactation counselor and educator (CLEC) and her beautiful family

2. Educate Yourself (and Your Partner!)

This is probably the most important thing you can do to prepare to breastfeed before entering the hospital. Breastfeeding education will help you set realistic expectations of what breastfeeding in those early days may look like, provide you with information on how to achieve an effective latch and adjust positioning for comfort, ensure you have some basic troubleshooting tools, allow you to identify and solve issues before they become serious problems, and empower you to be confident in your breastfeeding journey.

3. Have Some Conversations

Breastfeeding is a relationship between you - the breastfeeding parent - and your baby. But making sure that your birth and postpartum support systems are aware and on-board is helpful in ensuring success. Open up discussions with your partner and/or your support person, and let them know what your goals and expectations are for breastfeeding. Make sure you're discussing your wishes with your OB/GYN or Midwife as well as any doulas or other supporters who will be helping you throughout your birth. If you'll be having help after baby arrives - whether it's your mom or neighbor or postpartum doula - make sure they're aware of your wishes, as well. And if you’ll be returning to work after the baby is born, discuss your breastfeeding goals and wishes with the baby’s caretaker(s) and the right people at work. To reach your breastfeeding goals, you’ll want as much support and understanding as possible, which means it’s important to ensure everyone is on the same page and offering the support that you need, how you need it, and when you need it. The more aware those around you are of what you want, the more they'll be able to help you get there.

4. Develop a Support System

Some of the most important support systems we've found are the ones that we don't realize are at our disposal before we give birth. Find a local La Leche League chapter or breastfeeding support group and attend meetings prenatally. You'll be surprised (and really thankful) that you got first-hand insight on breastfeeding challenges and triumphs before baby arrives.

It is also so incredibly important to make sure you've got an advocate with you during birth and a support system available to you postpartum. Consider hiring birth and postpartum doulas, find out what your and your partner's family leave policies are, and don't be shy about sharing what will be helpful (and not helpful) to you postpartum with friends, family and neighbors asking to help.

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5. Prepare Your Toolbox

Prepping for baby can be a lot of fun as you design the nursery and buy clothing and blankets and tiny shoes. Make sure that, while you’re out picking things up for the new babe, you remember to pick a few things up for your breastfeeding toolbox. You don’t need much to successfully breastfeed, but there are a few things that might make those first few days and weeks a little easier and more comfortable.

I always recommend having the following things readily accessible (preferably in a basket or bin stationed near a nursing spot) once baby’s here:

Make sure that, while you’re out picking things up for the new babe, you remember to pick a few things up for your breastfeeding toolbox.
— Cristina Toff
  • Nipple salve - nipple care is important whether breastfeeding is off to a great start or whether you’re experiencing discomfort from a shallow latch in those early weeks. Apply nipple salve or balm or even some coconut oil between feedings to keep your nipples moisturized and protected.

  • Nursing pads - to keep your clothes dry in between feeds

  • Burp cloths / swaddles

  • Water bottle - while there’s no need to drink an excessive amount of water while breastfeeding, staying hydrated is important for our health and energy, so don’t forget about taking care of yourself, too.

  • Nutritious snacks - we burn about 500 extra calories a day making milk, and it’s important that we’re fueling our bodies well.

Here are some nice-to-have items that you may want to consider having nearby as well:  

  • Hydrogels - for comfort if you’re experiencing nipple soreness

  • Warm and cold compresses - cold will be helpful if you find yourself uncomfortably engorged and warmth will aid in your milk let down (ejecting your milk) and help with any breast soreness

  • Ibuprofen - breastfeeding should not be painful but postpartum recovery may be quite uncomfortable. Ibuprofen and Tylenol are safe to take to ease your pain during this recovery period. If in doubt, ask your local pharmacist or check InfantRisk to check if a medication is safe to take while breastfeeding.

6. Adjust Expectations

Did you know that babies, regardless of breast or bottle, feed for a total of about seven hours a day? Misaligned expectations are often cited in breastfeeding research as one of the biggest barriers to breastfeeding success, so it’s important that you’re aware of what is realistically going to happen in those first few days, weeks and months.
— Cristina Toff

Did you know it is completely normal for babies to lose 7-10% of their birth weight and this can be even greater for babies born via c-section? Or that small amounts of colostrum are the perfect amount for our tiny baby’s belly and our milk increases in volume around 3-5 days postpartum? Did you know that babies, regardless of breast or bottle, feed for a total of about seven hours a day? Misaligned expectations are often cited in breastfeeding research as one of the biggest barriers to breastfeeding success, so it’s important that you’re aware of what is realistically going to happen in those first few days, weeks and months.

Setting realistic expectations about what to expect in those early days with your body and baby’s behaviors helps us identify what is normal and abnormal, prevent many issues and discomforts and saves you a lot of frustration, confusion and uncertainty if you do run into challenges.

August 28, 2018 by Alina Jiwani