Laurie B. Jones, MD, IBCLC
As research shows, breastfeeding delivers a laundry list of protections to both infant and mother during and beyond the breastfeeding relationship. The Centers for Disease Control (CDC) report that 77% of mothers in the United States plan to breastfeed their infants at the time of delivery; however that number drops to 50% after the first weeks. If you plan to breastfeed, this list will help you avoid the common problems that often prevent mothers from reaching their breastfeeding goals.
Assemble your team
• Choose an obstetrical provider that endorses skin-to-skin after delivery
(both vaginal and c-section).
• If you’re set on exclusively breastfeeding, choose a pediatric provider that supports giving only breast milk unless there is a medical indication.
• Deliver at a hospital that keeps you in the same room as your infant throughout the hospital stay. This includes bathing, the hearing test, routine exams by providers, phototherapy and antibiotics.
• Include your partner and close family in your plans for breastfeeding and pre-assign tasks to those who will help after baby is born (groceries, laundry, dishes, meal prep).
Avoid feeding traps
• Bottles release milk very fast, and in the first 3-4 weeks, you should avoid giving any bottles to protect your infant’s innate breastfeeding skills.
• You can have another family member give practice bottles before you return to school or work around the one-month mark–once breastfeeding is well established.
• A very small percentage of full term newborns will need supplementation for a medical reason and it should be mother’s own expressed milk (by hand or by pump) with formula as the last option.
• Any supplement should be delivered in the hospital by a route that protects breastfeeding oral skills (such as spoon, cup feeder, syringe, finger feeder, or supplemental nursing system).
• Avoid the use of pacifiers in the first few weeks when they can quench a newborn’s need to suckle and lower your future milk supply.
Trust your baby
• Newborn babies are born with reflexes that promote latching to their mother’s breast.
• Throw out the breastfeeding “rule book” – use whatever positioning feels comfortable for you. It might change from day to day.
• Each newborn has its own unique pattern of feeding (how many times per day and how many minutes each time). There’s no magic number but science shows that nursing at least 8-12 times per 24 hours without any “scheduling” will support a bountiful milk supply.
• Keeping track of wet/dirty diapers is how doctors and parents know if the baby is getting enough nutrition.
Trust your body
• Many women have anxiety about making enough milk. You have been making milk since around 16-20 weeks of pregnancy and whatever is removed after delivery by your baby will be made again the following day.
• Unless you have had certain breast surgeries or a rare hormonal condition, you will make enough milk for your baby if you feed the baby whenever he or she wants at the start.
• Each feeding on the first day of life is about 5-7 milliliters–just enough to fill a small teaspoon.
• Colostrum is a concentrated, power-packed liquid that provides exactly the right amount of food for the first three days until your breasts start to feel heavier as milk production increases.
Get help if you need it
• Breastfeeding is natural but it doesn’t just magically happen–it is a dance between mother and baby that unfolds in the first days. Keep visitors and interruptions to a minimum to allow the unrushed time it takes to learn your baby.
• Don’t let anyone tell you that breastfeeding should hurt. You don’t have to “tough it out” or “get used to it.”
• If it hurts, ask for help from your bedside nurse, pediatrician, or lactation consultant.
• Often a very small adjustment of positioning can get more of your breast milk into baby and stop the pain.
• Before the delivery, research local mother support groups, private practice IBCLCs (International Board Certified Lactation Consultant), and companies that rent or sell breastfeeding gear. Many lactation services are covered under health insurance plans.
Laurie B. Jones, MD, IBCLC, is a pediatrician at Dignity Health’s St. Joseph’s Hospital and Medical Center. For more information visit: www.dignityhealth.org/arizona