8 Steps to Help You Succeed
By Ann Calandro, RNC, IBCLC
Don’t just try breastfeeding. Succeed. If you want to assure success with breastfeeding, be proactive and plan ahead. You and you alone are in charge of your success. Don’t wait for someone else to make it happen. Be a participant, not an observer. Why? Because there are many seemingly innocent interventions that you can “choose not to choose” that are often the root of breastfeeding problems. Some of these may surprise you.
I’m not going to pussyfoot around and be nice. I have talked to too many mothers lately who have had really difficult problems, many of which probably could have been avoided. Instead, I am going to share a simple roadmap to breastfeeding success. Are you ready?
If you want to assure success with breastfeeding, be proactive and plan ahead.
Step 1: Hit the Books
During your pregnancy, read, read and read about breastfeeding. Make an itinerary. Don’t waste your time reading any material that has been published by a maker of infant formula. These booklets are carefully written and omit most of the important information you need to know.
Breastfeeding is the most important thing you will ever do for yourself and your baby. Formula-fed babies experience a whole plethora of problems that breastfeeding will avoid. Don’t leave your success to chance.
Step 2: Go to Class
Attend La Leche League meetings or other breastfeeding mother support groups. Most areas have local groups that will welcome you with open arms. Surround yourself with normal breastfeeding mothers and babies, and you will get a feel for the way babies nurse. Absorb the spirit!
Many young mothers have never had the opportunity to spend time around other nursing mothers. We are mammals. We learn by observation of other mammals. Since the beginning of time, it has been traditional for women to gather their knowledge from other women. If your hospital teaches breastfeeding classes, attend those as well. You will hear a lot of useful information, but don’t skip the LLL meetings. Attend both.
Step 3: Shop for Your Doc
If a particular OB office readily hands out attractive formula packs and information, you might want to search elsewhere for a provider who really supports breastfeeding. Signing up for a “Baby Club” is an invitation to have propaganda mailed to you at home specifically aimed at changing you over to formula feeding. OB offices should not be participating in these advertising promotions.
Instead of using un-breastfriendly providers, ask the successful mom beside you at the LLL meeting for a recommendation. LLL leaders cannot give recommendations, but there is nothing wrong with asking other mothers at meetings. After all, these moms are happily breastfeeding. How’d they do it?
If you have a choice of hospitals, pick the one that encourages rooming in and has the pediatricians do examinations in the mother’s room. When you visit Labor and Delivery, ask how long your baby will stay with you after birth. The most breastfeeding-friendly ones allow unlimited bonding time. If you don’t have a choice, remember that you are a consumer. You are not required to follow hospital routines that do not support successful breastfeeding. Be sure your hospital has a board certified lactation consultant to assist you and answer your questions.
Step 4: Be Patient
You will need to be carefully monitored the last few weeks of pregnancy to be sure your baby is growing and you are healthy. Medical problems with you or your baby may make early delivery by induction necessary. However, induction because you are tired of being pregnant is a terrible idea. So is induction mid-week because it is more convenient for your provider. Unless you have medical problems that make it necessary, induction is like gambling – you may or may not be successful.
Ultrasound is far from perfect. It may tell you that your baby is large enough to be born, but you could just have a large premature baby. Babies born as early as 37 or 38 weeks do not always nurse well. Many times these little ones are sleepy and disinterested. Your due date could be wrong. You may end up having a baby who is technically still a premature baby of less than 37 weeks gestation. It happens all the time.
Induction is an invitation to a Cesarean section. Your body may try its darndest to keep the baby in, knowing it’s not time to be born so the induction may not work. Then there you are, with major abdominal surgery, in pain, trying to work with a baby who is sleepy, early and not interested in breastfeeding. Then, the formula magically appears (TA DA!) and the cycle of formula feeding begins. Or the baby doesn’t eat, sleeps all the time and gets jaundiced. (Early babies are more prone to jaundice.) Then the formula will also appear, and Baby will be placed under bilirubin lights as well. This means separation from Mom, plus getting formula, meaning the breastfeeding will probably suffer.
On the other hand, if the induction does work, your contractions will probably be more forceful and painful than normal contractions. Then the two of you will be more likely to take more and more medications.
Be patient and wait your pregnancy out. Don’t have your baby when it is convenient for you or your health care provider. Let your baby pick his own birthday. In some areas, this is a novel idea indeed.
Step 5: Make a Birth Plan
Your birth. YOUR birth. This is a time for you to always remember and cherish. You are in charge of this trip. You decide what you want and what you do not want. It is also your baby’s birth. It’s not just about you. Whatever you decide will also affect your baby. Medications, including epidurals, will affect your baby to some degree.
Who says you can’t have a natural birth? Women are strong and courageous. Women have been birthing for thousands of years. It is not comfortable, but it is doable. Train for your journey by attending childbirth classes, real ones that teach you useful techniques that will help you deal with contractions in a drug-free way. Babies born medication-free are almost always wonderful breastfeeders. Natural birth is a gift you give yourself. You will carry it with you always and it will be one of your proudest achievements. I kid you not.
Epidurals and all other interventions may negatively affect your breastfeeding. Have you ever wondered why some babies refuse to nurse? Why some babies suck incorrectly? Why some babies fail at breastfeeding, the God-given natural way of supporting life? It is not the baby’s fault in most cases. It is the fault of the medication, the vacuum extractor that pulled the baby out and misaligned the jaw and left the baby with a bummer of a headache, the prolonged labor caused by an epidural given too early or one of a whole variety of problems that medically managed birth may cause. Make a birth plan. This is your personal road map. Bring it to the hospital. Share it with your nurse and your physician or midwife. Stick to it.
Step 6: Shop for Baby’s Doc
It is important to find a breastfeeding-friendly pediatrician. I doubt you will find a single one who doesn’t believe in breastfeeding, but many only “talk the talk” and don’t “walk the walk.” Many are quick to fix any problem with formula. It is an easy fix. Many pediatricians know very little about helping you manage breastfeeding. Their mantra is, “Don’t make Mom feel guilty.” This is a paternalistic attitude and it just stinks. Just how guilty will Mom feel if she realizes later that fixing her breastfeeding problem may have prevented her baby countless ear infections or lifelong allergies?
So how do you choose a breast-friendly pediatrician? Ask successful breastfeeding mothers. Attend the above-mentioned LLL meetings and ask for recommendations. The yellow pages are not your friend. Let your legs do the walking, not your fingers. Get yourself to that meeting. If there are no meetings in your area, ask a breastfeeding friend or friend of a friend for a recommendation. Sometimes you have little choice in your provider, and the insurance companies or health department will choose for you. In this case, it is more important than ever to be ready to protect and defend breastfeeding for you and your baby.
Step 7: Welcome Your Baby
After your baby is born, breastfeed as soon as your baby shows signs of hunger, such as chewing his hands. Do not let hospital staff take him away for any reason if both of you are doing well. Wearing only a diaper and a cap, your baby should slide right in the front of your hospital gown and stay skin to skin with you until your first breastfeeding. After the first breastfeeding, it is Dad’s turn to do the skin-to-skin thing. No rush on a bath. No rush on anything except this first hour or two of bonding time.
After waiting nine months for this baby, you need get-acquainted time with this wide-awake miracle. You can eat a meal with Baby snuggled right there. You can drink with Baby there. You can take a nice long soak when your baby goes to that long sleep stage after a couple of hours or while Daddy holds him skin to skin.
Nurseries are not a good place for babies. Room in. LIMIT VISITORS! Don’t have any visitors if you can help it. (Except close family and then just for short visits!) Encourage them to visit after you are home and have established your breastfeeding and had a little time to rest.
Ask for your baby to have vital signs and exams in your room. Give staff no opportunities to introduce a bottle or a pacifier to your breastfeeding baby. If you believe this never happens, I have some oceanfront property I’d like to sell you when the tide goes out! Go with your baby for checkups or hearing screens if they are not done in your room. Take a little card with you to the hospital for your baby’s crib that says, “I am a breastfeeding baby. Do not give me any formula, bottles or pacifiers!” You are your baby’s advocate.
Step 8: Just Breastfeed
Nurse and nurse and nurse. You cannot overfeed. You are not being used as a pacifier. You want your baby to nurse every time he wiggles so that your baby will get your bountiful milk quickly, won’t lose more than 7 percent of his weight (another reason formula appears) and will not get jaundiced. Hold your baby all day long! Babies born naturally are quite good at frequent feedings. In fact, home-born babies are usually gaining weight by two days of age. Hospital-born babies don’t begin gaining weight for many days. What could be the difference? Probably the fact that home births are unmedicated and there is no routine separation of moms and babies.
The new hyperbilirubinemia guidelines that many hospitals have adopted can be extremely unfriendly to breastfeeding. Formula and bili lights may be started at the first sign of yellow skin. If your baby is being treated for jaundice, breastfeeding may be jeopardized. It is not healthy for babies to have high bilirubin levels, but a proactive mom can do everything in her power to help prevent her baby’s levels from going up by very frequent feedings. This will promote frequent stooling, which will decrease the chances of Baby having to undergo treatment.
Sometimes even the best laid plans go awry. Don’t hesitate to communicate to your caregivers that you want your baby to only receive breast milk. If your baby has a medical need for a supplement, it can be easily done with a cup, syringe or spoon. Bottles are unnecessary. The food of choice is breast milk. You can express out a little by hand, or you can get a good breast pump and use it to get a spoonful or two for your little one. The secret to continued success when bumps in the road appear is a positive attitude and determination!
Don’t sit back and let someone else take charge of your pregnancy and birth. Cheerfully listen to all available options, ask questions and then make decisions – your own decisions. If you don’t know where you’re going, you may end up someplace else. Good intentions are only good intentions. Follow them up with actions. Bring your road map. Use it.