Breastfeeding newbornSo much to discuss about getting ready for breastfeeding that it's a double post. Read last week's tips here.

Lucia Jenkins, IBCLC, the executive director of Baby Cafe USA, shared these suggestions with me. “Learn to hand express some colostrum. Around the eight-month moms start to be able to do this. Try to find a hospital that is Baby Friendly. Make sure you do immediate skin to skin for at least an hour. The baby’s bath and weight check can wait. They aren’t important. What’s most important is that baby has mama. Your baby’s vernix is extremely protective.”

Plan to keep your baby with you postpartum. Known as rooming in, babies who sleep in their mothers’ rooms are happier and cry less. Studies show that moms who room in get similar amounts of sleep to moms whose babies sleep in the nursery. Learning to read your baby’s early hunger cues and nursing him or her frequently initially helps to get breastfeeding off to a good start. Understand the risks of your baby having even one bottle of formula in the hospital.

The choices you make for your labor and birth can affect your breastfeeding experience in the beginning. Common pain medications, Pitocin, vacuum delivery, and cesarean birth can all increase the learning curve in the beginning. Even something as simple as an IV in labor can result in overhydration for you and your baby. A mom who is over-hydrated will have swollen breast tissue which makes it more challenging for her baby to latch. A baby who is born over-hydrated will initially have excess fluid, which increases his or her birth weight. This can cause the baby to lose more weight (greater than 10%) of his or her birth weight, which can result in formula supplementation. Using the twenty-four-hour weight, rather than the birth weight, is more accurate in this situation. Labor interventions are sometimes necessary, and moms can go on to successfully breastfeed afterward, but breastfeeding should be seen along a continuum that includes pregnancy and birth. If you know you will be giving birth by cesarean, discuss with your doctor prenatally breastfeeding and holding your baby skin to skin in the operating room.

When interviewing pediatricians, ask how they will support you during breastfeeding. Pediatricians don’t learn much about breastfeeding in medical school, so expect that they will refer you to an International Board Certified Lactation Consultant (IBCLC) if problems arise. IBCLC is the gold standard when it comes to lactation support. They are usually available for consultation in the hospital during the postpartum period. You can also find an IBCLC who will visit you at home.

Check with your HR department to make sure you will get pumping breaks and a place to pump that is not a bathroom when you return to work. Federal law protects these rights. If you are in the military you can get support through Breastfeeding in Combat Boots.

A common concern that many moms have is breastfeeding while taking medications. Most meds are compatible with breastfeeding, or there is a similar one that is. Discuss the safety of the medication with your pediatrician, not the prescribing doctor. Call the Infant Risk Hotline for specific information about the safety of your medication.

Some of my fondest memories of my daughters’ early years are of breastfeeding. But I also remember the steep learning curve in the beginning, and some very long early nights when I wondered why people kept talking about how fast those first years go by. Now I see that while the days (and nights!) can be long, the years are short. Preparing for breastfeeding during pregnancy will make those first days easier.

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