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Breastfeeding is a daunting task, especially for new moms. Our Expert & Family Medicine Physician,
Dr. Rebecca Berens, gives her tips for preparing to breastfeed before you welcome baby!
In the early days, the most important things to establishing a good breastfeeding relationship are 1) lots of contact between parents and baby, and 2) access for feeding whenever the baby is ready to feed. This is an extremely important time for parents to learn to pick up on feeding cues, since once baby is crying with hunger and agitated it is much harder to start a feed and get a good latch. Skin to skin contact between the breastfeeding parent and baby is also extremely important for supporting a good breast milk supply.
But remember, you need help and support to breastfeed! Here are some important things to do before you give birth.
1. Talk to Your Family
Well-meaning family and friends want to help, but will often come over and insist on holding the baby -- this is not helpful to you. One thing you don't need is other people's opinions! There are many other ways that they can help support you as a new parent, such as:
•Do chores
•Watch other kids
•Cook/bring you food
•Change diapers
•Bathe baby
•Play/tummy time
•Read stories
•Soothe to sleep
It is much easier to set boundaries and expectations about how you want your family and friends to support you BEFORE you give birth -- in the postpartum period you will be tired and hormonal and possibly overwhelmed. At that stage, it is very hard to have an honest conversation with people about behaviors you would like them to change. You should also talk to your partner about your goals and expectations so that they can intervene and navigate any conflicts for you, especially if their side of the family is involved.
2. Talk to Your Doctor/Midwife
This is incredibly important because there are certain conditions that can put you at risk of difficulties with breastfeeding. It is important to discuss with your doctor or midwife during prenatal care whether you have any of these risk factors and what you can do to give yourself the best chance of success. Often there are several things you can do to help. Additionally, it is also mentally helpful to know in advance that you may have difficulty. A lot of women put pressure and blame on themselves when they experience breastfeeding difficulties.
If you are having trouble, it is not your fault! We have significantly less societal support for new parents than we did in the past, and there are medical conditions that can contribute to problems as well. Arm yourself with as much information as possible, and then if you do encounter struggles, you will know who to go to and how to address them without self-blame.
Possible risk factors for difficulty breastfeeding include:
•Diabetes/insulin resistance
•Thyroid disease
•Lack of breast growth in pregnancy
•Tubular breasts
•Inverted nipples
•History of certain breast surgeries
•Older age
3. Talk to Your Employer
Talking to your employer (whether that be your supervisor and/or HR department) while you are still pregnant about your plans to breastfeed is important to make sure that they give you the accommodations you are entitled to. Sometimes they will need some time to prepare for these accommodations, and they will appreciate the notice from you to make sure things are done correctly.
Before talking to them, it is important that YOU know what your rights are. There are both federal and state protections for breastfeeding women in the workplace. Keep in mind that you are not asking permission for these accommodations, you are already entitled to them. You are simply notifying them that you have a condition that will require workplace accommodations, and telling them what the accommodations are that you will need. It is difficult to do this on short notice in the postpartum period, and many women feel pressure/guilt upon returning to work to return to their previous work schedule. Please do not feel any guilt about asking for accommodations! If you encounter retaliation or discrimination in the workplace due to these accommodations, please know that this is illegal and notify your HR department.
Here's what you'll need to pump at work:
•Private space with outlet and locking door
•Sink to wash hands and pump parts
•Fridge or cooler to store pumped milk
•Bag to carry supplies to and from work and a secure place to store them while there
In terms of WHEN to pump are work, you will need to plan to pump every time the baby feeds while you are separated (usually at least every 3 hours). A double-electric breast pump is most effective. Expect to pump for approximately 20 minutes if pumping both sides simultaneously. Make sure to factor in travel time to the pumping location and time to clean and store the milk and pump parts.
4. Order a Breast Pump
Most insurances cover breast pumps at 100%, and if the ones they cover at 100% are not the one you would choose, they can usually subsidize the cost of an upgraded model to limit your out-of-pocket cost. I recommend everyone take advantage of getting a breast pump EVEN IF YOU DO NOT PLAN TO PUMP FREQUENTLY! You never know what might happen and it is better to have it just in case.
Bring the pump with you to the hospital so that the lactation consultant can make sure you know how to use it and that the breast shields fit you properly. Most private lactation consultants will also assist with orienting you to your pump at home and troubleshooting any issues. Most major pump brands have videos online that show how to use them as well.
5. Stock Up on Other Helpful Supplies
Breast Pads -- these you put in your nursing bra and are essential for catching leakage, especially common in the early days. They come in reusable/washable and disposable forms.
Nipple Cream/Ointment -- important for using in the early days to protect the nipple as you adjust to the new sensation of breastfeeding. Can help protect against skin breakdown. These come in many forms, many contain lanolin which some women have skin reactions to. I recommend trying the one you buy ahead of time to make sure you do not have a reaction to it.
Nursing/Pumping Bras -- nursing bras make it easier for you to access your breast while nursing. They are also more comfortable and supportive and can prevent excess pressure on the breast that can lead to milk duct clogs and soreness. A pumping bra will hold the breast shields in place while you pump to allow you to double-pump hands-free (this is essential if you plan to pump at work). There are some bras that are a combination of a nursing and pumping bra, which I think these are much easier to use and wear under clothing at work than some of the strapless pumping bras that are bulky and have to be taken on and off.
Hakka -- (pictured above, there are other similar brands as well). This is a low suction type of pump that can be used to collect excess milk leakage in the early days as well as relieve engorgement. This can allow you to store some extra milk to have on hand for supplementation or as a back-up when you are separated from your infant. Milk savers are inserts that go inside your nursing bra to collect drips, they do not have any suction. Both of these can be used on one side while the infant is nursing on the other side.
Milk Storage Bags -- these are medical grade storage bags that allow for clean storage of any collected or pumped breast milk. You can store milk in these bags in the fridge or freezer (the CDC has some helpful milk storage guidelines).
For more helpful tips, Dr. Berens is available 24/7 on SocialMama to answer your questions!
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About the Contributor:
Dr. Rebecca Berens is a board-certified Family Medicine Physician with expertise in Women's Health and Breastfeeding Medicine. Her holistic approach serves patients from newborns to elderly, focusing on the physical and mental well-being of each family member. She is the practitioner at Vida Family Medicine in Houston, TX, and is an Expert on the SocialMama app!
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