By Kendall Sonnenberg, International Board-Certified Lactation Consultant
While many moms-to-be know they want to try breastfeeding, the truth is that breastfeeding success doesn’t usually “just happen”; it takes education, support, and focused effort. Luckily, a little preparation can go a long way. Just like you might be creating a birth plan, it’s just as important to make a breastfeeding plan. Getting ready for nursing while you’re still pregnant and knowing what to do in the first hours after birth can have a huge impact on your milk supply and help to establish breastfeeding over the long term.
As an international board-certified lactation consultant, I’m often asked how to create this plan, and what knowledge and items you should have before your baby arrives. Below, I’ll share some of the ways that you can set yourself and your baby up for success.
Start by thinking about your breastfeeding goals
A great place to start is simply setting your goals. If you want to breastfeed, think thinking about why it’s important to you. If you are unsure about this, I recommend that you speak with your care provider or a lactation consultant to get answers to any questions you may have.
Making a case for yourself and this journey ahead can be a very personal process. While some people may want to breastfeed as long as they can, others may have a goal of nursing until the end of maternity leave or until the baby reaches a certain age. Some may plan for exclusive breastfeeding, while others may want to do a combination of breast- and bottle-feeding. If you’re expecting your second child, your goals may be influenced by how things went the first time. But no matter what your goal is, there's no one correct way to do it. What’s important is that you start making the plan while you’re still pregnant, not after the baby arrives.
Identify breastfeeding education opportunities
It’s ideal to start talking to your care provider about breastfeeding in your second or third trimester, depending on your learning needs. While he or she may not be an expert on lactation and nursing, they can surely refer you to someone who is. You may be surprised at how many resources there are once you start looking. Some personal favorites of mine are the videos on Stanford Medicine’s breastfeeding pages, and articles from LaLeche League.
You can also consider attending a class in your area with your partner, or if it’s more convenient, check out some of the great online course options. In these sessions, you will learn the basics of your anatomy, how to get started, what issues you might run into, and how to make the most of the “golden hour.” Having a prenatal visit with an IBCLC can give you a more in-depth look at your specific needs as well as identify any physical or health-related challenges that may impact your ability to breastfeed successfully. Prenatal education has been shown to improve breastfeeding rates at 6 months postpartum, so make sure to take the time to gain as much knowledge as possible.
Learn the importance of the “golden hour”
If I had only 30 seconds to educate moms-to-be on the most important information about breastfeeding, I would tell them: start moving your milk early and often during the first three days after your baby is born. This starts immediately after delivery, during what is called the golden hour. This period – literally the first hour or so of their life – is the most critical time to start removing milk from your breasts, either by the baby, a hand, or a pump.
Studies show that if a baby breastfeeds (or milk is removed via hand or pump) during the first hour of life, the likelihood of establishing a full milk supply will increase. One study from Breastfeeding Medicine showed that mothers who removed milk during the first hour compared to those who removed milk between the second and sixth hours after birth had 70% higher milk volume on day seven.
When it comes to breastfeeding challenges that arise, there are many issues that can be fixed. But if you don’t have enough milk supply at three or four weeks postpartum, it can be difficult to rewind the clock if you haven’t established your milk supply from the beginning.
To make the most of these first moments, the baby should ideally be placed on your abdomen right at birth. You should be skin-to-skin, and the baby should be given the opportunity to crawl toward your breasts and initiate the first feed. Much of the standard newborn care that’s done right after birth (measuring, washing, etc.) should be delayed until after this first feed. If your baby needs extra assistance transitioning to the world, he or she may be taken to a warmer or the NICU. While this can be stressful, keep in mind that your milk is medicine! Hand expressing your colostrum in this first hour will benefit your ability to make milk, even weeks or months after birth. If you wish to start breastfeeding at the golden hour, you should write this into your birth plan so that your healthcare team is aware.
Know what to expect during the first week
In the early hours and days of life, babies are very sleepy, and it might not always seem like they want to feed. But to establish a good milk supply, it’s important to put the baby to the breast frequently; this sends a signal to your body that it needs to keep making milk, which is a dynamic process based on supply and demand. In other words, your breastmilk must be removed before it can be replaced.
If you are separated from your baby for any significant period – for medical procedures, or to give you a chance to rest - make sure you’re still removing milk from your breasts, either with your hand or an electric pump.
It’s also important to remember that the routine can change quite drastically once your milk changes from colostrum to mature milk on day 3-5. When your milk transitions, the volume increases and the color changes from yellow to white. At this point, your body will often produce more milk than a tiny baby can handle, and this can cause breast engorgement. Make sure to continue to put baby to the breast frequently but know that their feeding pattern might change a bit with this new influx of milk. They may go from feeding every hour or two, to having some longer breaks in between feeds. Make sure that they are fed every few hours, day and night, and monitor their weight as scheduled by the pediatrician.
Prepare your home and invest in a nursing pillow
Since you’re probably already in “nesting” mode, make sure that as you’re preparing your home for your baby’s arrival, you’re also prepping it for breastfeeding. Set up some calm spaces, for example, in your bedroom or a chair in the baby’s nursery, with everything you need to be comfortable and focus on feeding. This can include a little basket of comfort items such as a water bottle, nipple cream, a phone charger, a blanket or slippers for you, and – importantly - a nursing pillow.
Having a well-designed, supportive pillow can be crucial, especially in the early stages of breastfeeding. Nursing comes with a learning curve for both you and your baby, and you will probably find yourself hunching over to help guide the baby’s latch and support their weight. You’ll also be sitting or lying in fixed positions for multiple hours a day (and night). All this puts stress and strain on your back, shoulders, arms, and neck. Since you’ll also be recovering from labor and delivery, it’s important to prevent further pain and injury during these early days.
I love the bbhugme Nursing Pillow because you can tie it around yourself and adjust its height, which supports baby at the level of the breast, not down on your lap. This not only helps with establishing a good latch but also provides better alignment for your body. This kind of essential support helps you focus on the task of breastfeeding. I recommend getting your nursing pillow before the baby is born so that you can take it with you to the hospital for extra comfort during those first precious hours.
Just like every baby and birth experience, every breastfeeding journey is unique. While not everything may go according to your wishes, preparing for breastfeeding before your baby’s arrival can help set you up for success by giving you the knowledge, support, and tools you need.
About the author
Kendall is a Registered Nurse and IBCLC (International Board-Certified Lactation Consultant), and she has worked closely with mothers, babies and their families for the past 14 years. Her experiences working as an RN in high-risk pregnancy and postpartum hospital units as well as fast-paced pediatric and OB/GYN clinics has given her a unique clinical skill set. She can provide expert care for families during all stages of pregnancy, postpartum and beyond, thanks to her well rounded professional experience.