Preparing to Breastfeed
Breastfeeding is an amazing way to nourish your child; it is important for both of you for so many reasons. Breastfeeding is often a huge learning curve for both Mom and Baby. The frustrations that are common in the early weeks can be exacerbated by the normal hormone fluctuations you experience, lack of sleep, self-doubt, naysayers and plain old exhaustion.
I wish I knew some of what I am going to share with you before starting on my breastfeeding journey.
Prepare mentally for breastfeeding. It sounds silly, but a positive attitude can make all the difference in the world. Firstly, if you have had a previous experience with breastfeeding, analyze what was good and what you would do differently about your experience. Let go of any remaining emotions or guilt that may still be present. It may help to discuss your previous experience with a Lactation Consultant and see if there was anything that could have been done differently that you may want to change this time around. Similarly, if this is your first experience, think about any concerns you have and discuss them prenatally with a Lactation Consultant. Many Moms have it in their head that they may not be able to breastfeed because of something like the appearance of their nipple, or someone else in their family who did not reach their breastfeeding goal but there are many things that can be done to remedy these concerns. Setting yourself a reasonable breastfeeding goal may also be helpful. “I am going to breastfeed for 3 months and get help in the first week this time”, or whatever makes sense for you. This goal can be constantly moved further as things get easier with time. If you enjoy reading books the book “The Motherly Art of Nursing” by La Leche League is a fantastic book to read prior to deliver or after for support. Lastly, know who your supporters are and turn to them after baby comes; whether they are friends, family, group support or a Lactation Consultant.
Try to minimize interventions in labour. This includes things like, IV fluids, early epidural use, induction, and caesarean section. Obviously some of these cannot be avoided sometimes, and if they do happen it doesn’t mean you won’t be able to breastfeed. The fewer interventions, the easier the breastfeeding should be. If you have any interventions in labour it is a good idea to schedule a breastfeeding check in back at the hospital, in a public health clinic or with an LC in your home in the first week to make sure breastfeeding is going well.
Spend lots of time skin to skin snuggling your baby and start breastfeeding as soon as possible after birth. Your baby will be alert and ready to feed the first two hours after birth; thanks to a healthy release of hormones during labour. Take advantage of this time and snuggle close. Your partner can do skin to skin if you are unable to due to complications. Initiating breastfeeding during these first 2 hours has been shown to increase breastfeeding success rates. Feeding in the first hour is even better, it is often referred to as “The Golden Hour”. After these initial 2 hours your baby will get sleepy and so will you. So hold off all those excited visitors during this time and enjoy the moment.
Get help early. If your baby and you are having trouble with latching, ask for help early! Ask your nurse in the hospital for help, or ask to see the hospital Lactation Consultant. Make sure you get a good latch each time to prevent damage; it can make future nursing sessions more painful even with a good latch. If the latch is painful, unlatch and try again. Hand express a small amount of colostrum after each feed and rub it on your nipple and areola, allow it to air dry to help protect and heal nipples. If you have damage on your nipples, you have been having a difficult time in the hospital breastfeeding, you are supplementing baby with breastmilk or formula or you are using a nipple shield or tube at the breast; receiving follow up support once home is crucial to a successful breastfeeding journey.
Start hand expressing as soon as possible after birth if any of the following is happening: your baby is very sleepy (and not feeding well), having trouble latching, or separated from you due to health concerns; this will help with your milk supply. In a study hand expression after feeds in the first two weeks made for more milk at two weeks than a group that was not hand expressing. Ask your nurse or hospital Lactation Consultant how to hand express. Watch this video on hand expressing: https://www.healthyfamiliesbc.ca/home/articles/video-hand-expressing-breastmilk
If feeding difficulties continue or you are going to be separated from baby for a while, start pumping with a hospital grade pump. If you need to pump, ensure you speak with a lactation consultant for tips on how to establish your supply and properly remove milk from your breasts using a pump. Spend as much time as possible skin to skin if your baby is having trouble latching or separated from you, this will help with your milk supply and help wake up a sleepy baby. If baby cannot feed the normal 8-12+ times in 24 hours that a newborn would you need to hand express and pump the same amount of times to remind your body you want that precious milk.
Ask about what is normal. If you are concerned about something, ask friends, family, or a lactation consultant what is normal. There are many things that cause families worry but are totally normal. Things like cluster feeding, fussy evenings, growth spurts, and changes in your breasts; to mention a few. Know what to expect from their diapers. I wish breasts would turn see through or would have a gage with notches that goes down as baby feeds so it would be obvious how well they fed, because this is not possible the best way to know your baby is doing well is to watch for normal diaper output. They will not pee and poo if they are not taking milk from you!
Day 1: 1 pee, 1 dark poop
Day 2: 2 pees, 2 dark/brown poops
Day 3: 3 pees, 3 green poops
Day 4: 4 pees, 2-3+ green/yellow poops
Day 5(and beyond): 6+ pees and 2-3+ mustard yellow poops
Hearing from other Moms, or an expert like a lactation consultant, can help you rest at ease or provide you with tips for how to get through these norms.
Hang in there! Get that support if you are feeling frustrated, and use those supporters you have surrounded yourself with to be your cheerleaders. When everything is right (latch, supply, etc.) breastfeeding will just continue to get better; Your baby becomes more efficient at feeding and you both get the hang of breastfeeding and each other!
I am always happy to answer questions or provide support!
Katie Wickham BScN RN, IBCLC
Babies First Lactation and Education
Providing in home expert breastfeeding help. Serving: Newmarket, Aurora, Keswick, Richmond Hill, Vaughan, Sharon, East Gwillimbury, Kleinburg, Schomberg, Tottenham, Bradford, Alliston, Beeton, and Cookstown.
updated February 2018 originally posted in 2012