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    How to Prepare to Breastfeed

    breastfeed

    Preparing to Breast/Chest Feed

    There are many things you can do during your pregnancy to help prepare for breast/chest feeding. The checklist below will help set you up for success, but will also help you have a plan for if the start of your breast/chest feeding journey is a little rocky. Your steps of preparation now will come in handy. Learning about what to expect and discovering some tools to make life easier after the baby arrives will enable you to spend less time worrying and more time enjoying your new baby.


    Your prenatal checklist


    Meet your local, private practice IBCLC (International Board Certified Lactation Consultant)

    Schedule a prenatal consultation. You will be able to ask individualized questions, share your excitement as well as any fears or concerns you have. As you and your IBCLC walk though your complete health history, they will assess your breast/chest anatomy and ask about changes you are experiencing during the pregnancy, go over diet and supplements  and discuss what you are wanting your breast/chest feeding journey to look like. If you had problems nursing any of your other children, your IBCLC can offer information to hopefully avoid the same struggles from repeating. Meeting and connecting with an IBCLC before having your baby makes it much easier to reach out after your baby is born if the need arises.


    Take a  prenatal class

    Prenatal classes are offered by Midwives, hospitals and lactation specialists. You will want a class that covers the basics of breast/chest feeding and newborn care. During the class, you will learn about different breastfeeding positions. Using a doll, you can give those positions a try. You will learn about what to expect during the first days and weeks of nursing a newborn and how to care for them. Take a local class so you can connect with and meet other parents who are also expecting.


    Know what’s normal

    Babies eat, pee, poop, sleep and repeat. It will be a new rhythm to get used to as a parent. Your baby will eat every 1.5 - 3 hours.(1) Sometimes your baby will want to nurse more often. Keep your baby close and follow their feeding cues. Knowing what to expect and what to look out for helps catch potential problems early on. 


    After your baby is born, being skin to skin with you is the best place for them to be. Skin to skin contact helps regulate the newborn's body temperature, heart rate, respiration and gives them the opportunity to begin breast/chest feeding within the first hour after birth. Your baby will start looking for the breast/chest by using their reflexes to crawl up to the nipple and nurse.


    Colostrum is high in protein and fat and contains everything your baby needs for their first few days of life.(2) Your baby eats about 1 - 4 Tablespoons of colostrum at each feeding. It is very concentrated with nutrients and has protective antibodies to strengthen their immune system.(3) Colostrum also acts as a laxative and helps the baby pass meconium which are dark, tar like stools which will transition to softer, seedy, mustard colored stools as your milk supply also transitions.


    More copious amounts of milk begin to flow between days 2 - 5 after birth. Your milk doesn’t change all of a sudden, rather transitions from colostrum to milk that is much higher in water content and carbs. This milk continues to meet your baby’s needs for calories and hydration. When milk is removed, it signals the breast to refill. It is the frequent emptying and refilling of milk from the breast/chest that leads to a milk supply to meet the needs of your growing baby.


    Wet and poop diapers will increase over the first several days. After day 4, you can expect your baby to have at least 8 very wet diapers and several poop diapers per 24 hours. 


    Babies sleep in small chunks of time, waking often to eat. Remember, they have a little belly and are growing super fast.


    Planning ahead

    Write in your birth plan your desire to breast/chest feed your baby and do not want your baby to have any artificial nipples. Your milk is the perfect food for your baby. The need for additional supplementation is not needed unless there is a special circumstance that your doctor or care provider brings to your attention. Give a copy of your plan to your healthcare providers and the hospital or place you plan on birthing your baby. This will alert the nurses and doctors that attend to you and your baby not to offer a pacifier or supplements without your permission and consent. 


    Pumping is not necessary for every lactating parent. If you want to be able to express your milk only on occasion you may not need a pump at all. A double electric breast pump is recommended if you will be returning to work and needing to remove your milk often. This is a good time to look into the many options out there as well as contact your insurance company to find out how breast pumps are covered.


    Learn how to hand express! This is an invaluable tool. Even if you do not plan on needing to ever pump or remove milk to store, there will most likely be a time in your nursing journey when you will be glad you learned this skill. It can be helpful in the beginning of breast/chest feeding if you feel engorged to relieve some of the extra pressure if your baby has already been well fed. Hand expression is a tool you always have with you with no needed extra parts!


    Collect your resources

    Find your local community resources for parent groups. La Leche League is one group that provides parent-to-parent support for breast/chest feeding. It is helpful to meet other folks nursing their babies, hear their experiences, tips and tricks. Each group varies, so if the first one you attend isn’t a good fit for you, try another one. There are also many groups with online meetings as an option. If you don’t have many family members or friends who you have seen nurse their babies, you probably have some curiosity and will benefit from the experience while in a comfortable group where you can ask questions and feel supported.


    Depending on where you are birthing your baby, find out what resources the facility will have available to you. If you will be at a hospital, ask about IBCLCs on staff for initial help with breastfeeding. Ask about using a pump if one ends up being needed during your stay as well as pump rentals.


    Some parents find working with a doula invaluable. Doulas help support the birthing and lactating parent based on your needs and wishes. A postpartum doula will help with various activities depending on what you are needing so that you can best care for your newborn. They can help with basic infant care while giving you emotional and physical support to adjust to this new life.(4)


    Family and friends can be great team players. Let them know what would be most helpful to you. It is important for you to be able to keep your baby close to establish your nursing relationship. Asking for help with folding that laundry, cooking a meal or spending time with an older child gives you the extra help you need and let’s those who want to be involved help in a meaningful way.

     

    Gather Supplies

    Purchase a well fitted, comfortable nursing bra. Remember, your breasts may become larger during breast/chest feeding over the first several days. Underwire is ok as long as the bra is well fitted and not putting pressure on areas that could contribute to a plugged duct.


    Having some throw pillows is useful. The nursing pillows sold make it hard to hold your baby in an optimal position for at breast/chest feeding. Best to stick with some comfy throw pillows you can use to support your back and arms while you support your baby.


    If you have a toddler or older kids at home, create a fun box for them. In the box, put some fun new books, toys, or (non messy) craft supplies like stickers and colorful paper. The idea of the box is that it only comes out when you are nursing your newborn. It can be a time your older child looks forward to.


    A nursing stool can be great to prop your feet up making it more comfortable for you to nurse. It is a nice extra!


    Learning about different types of slings and carriers you can nurse in now or purchasing a simple ring sling allows you to get to know your sling and how to use it before the baby arrives. It is a fantastic way to keep your baby snuggled close in a more hands free way so you can meet other kids needs. Babies need and love movement. It is very important for their development and reaching milestones. Wearing your baby to nurse offers extra support holding your baby and allows them to be in a good postural position to nurse.


    Just in case, have some Nip Dip on hand in case you do find you have some nipple tenderness from nursing your baby. An ice pack and heat pack can ease soreness in the early days as well.


    A Healthy You

    Your overall health is important for milk production. Now is a good time to add in more whole foods and remove processed foods from your diet. Add in veggies that include all the colors of the rainbow providing you with lots of vitamins and nutrients. Take a high quality, food-based prenatal vitamin.


    Stay hydrated drinking water and electrolyte beverages like coconut water. Making soups and stews with homemade mineral-rich broth are great for now and if you make double or triple batches, you can freeze the extras for a quick heat up meal after your baby arrives.


    Your body is going through so many changes and it may be hard to find a comfortable position while you sleep, but we know sleep is a big contributor to overall health. Use some pillows to support you where you need it most to be in a comfortable sleep position.


    Walking daily is a good form of exercise. Make sure to get the ok from your health care provider for your individual situation.


    Bodywork can keep your body in good alignment so you are comfortable as your belly grows, helps with getting better sleep, leads to easier delivery of your baby and fosters milk production.


    What You Don’t Need To Do

    There is some advice that is not recommended, but is still often given to parents. 


    You don’t need to  toughen up your nipples. The nipple has its own support system. The raised bumps on the areola called Montgomery glands secrete an oil that keeps your nipples moisturized. Fun fact, the fluid smells like the amniotic fluid and helps your baby navigate their way up to the nipple for feeding right after birth.(5)


    There is no need to rub a washcloth over nipples. This can damage the tissue and be painful.


    Avoid drying soaps on your nipples. Your chest may be extra sensitive so avoid lotions and creams directly on the nipples.


    Breast/chest feeding should never be painful. If you do experience pain, contact your IBCLC right away so they can help you uncover the reasons and offer solutions.



    Footnotes:

    1. https://www.cdc.gov/nutrition/infantandtoddlernutrition/breastfeeding/how-much-and-how-often.html#:~:text=Over%20the%20first%20few%20weeks,of%204%20to%205%20hours.
    2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586783/#:~:text=Colostrum%2C%20produced%20in%20low%20quantities,such%20as%20epidermal%20growth%20factor.&text=By%20four%20to%20six%20weeks,milk%20is%20considered%20fully%20mature.
    3. https://www.frontiersin.org/articles/10.3389/fped.2020.00428/full
    4. https://www.dona.org/become-a-doula/postpartum-doula-certification/
    5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761488/


    References:

    https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/jaundice.html#:~:text=Newborns%20have%20immature%20liver%20function,jaundice%E2%80%9D%20and%20is%20considered%20harmless.


    http://breastcrawl.org/science.shtml


    https://www.dona.org/become-a-doula/postpartum-doula-certification/


    https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/chiropractic-care-during-pregnancy-1191/


    http://mother-2-mother.com/normal.htm


    https://news.sanfordhealth.org/childrens/the-importance-of-skin-to-skin-after-delivery-you-should-know/





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