Dear SDBFC,

What should a first-time expectant mother who wants to breastfeed expect at the (big, traditional) hospital in the way of breastfeeding support? It would be nice to know what we're allowed to expect/ ask for. Should the hospital lactation consultants be sufficient or should we plan on working with an independent LC right away? Is there anything we can do before birth to help ensure smoother breastfeeding?

Sincerely,

Jenny

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Dear Jenny,

That is an excellent question, and to be honest very difficult to answer.  The type of breastfeeding support you will find at a hospital will vary greatly depending on which part of the United States you live in, whether the hospital is Baby-Friendly, its yearly breastfeeding rates, if they have certified lactation consultants (IBCLCs) on staff, and if their postpartum nurses have had recent breastfeeding training.  One hopes that the hospital lactation consultants will be fabulous, but that may not always be the case.  Also, a new mom typically won’t even see a lactation consultant in the hospital unless she is high-risk for breastfeeding challenges or she asks for one directly.

Since much of this may feel like it is not under your control, there are many steps YOU CAN make to ensure that breastfeeding gets off to a great start, regardless of the breastfeeding savviness of your hospital.

Here are my top 10 tips to prepare for breastfeeding before your baby is born:

1. Have a long chat with your partner.  Take turns discussing each person’s goals for breastfeeding and what type of support you may need from one another as a new parent.  Our article Partner Support: Can it make or break your breastfeeding experience shares different ways a partner can support a breastfeeding mom.
2. Take a fantastic breastfeeding class!  Don’t settle for the status quo.  Search for a class that not only covers the basics (latching, common concerns, how to know that your baby is getting enough), but also discusses local resources and is taught by a dynamic teacher with a background in lactation.  My favorite comment I saw on an evaluation of a breastfeeding class was, “the teacher even made my husband wish he could breastfeed!”  Now that’s a great class to attend!
3. Do some research about which hospital/newborn procedures are necessary during and after a birth.  Some hospital procedures are protocol, yet are not medically necessary for every baby, and can often negatively impact breastfeeding.  Here are two great podcast episodes about hospital protocols during labor and delivery  and hospital procedures after your baby’s birth. 
4. Read an informative and fun breastfeeding book, such as The Womanly Art of Breastfeeding or Ina May Gaskin’s Guide to Breastfeeding.  Both books give you information on how to prepare for breastfeeding and what to expect after your baby is born.
5. Attend a breastfeeding support group, prenatally!  First, you can see the lay of the land (where to park your car, where the group is located, and if the women seem like the type of ladies you would want to hang out with.)  Secondly, you can see women breastfeeding in their ‘natural habitat’….meaning, baby on boob, minus the cover, without feeling the need to cover up.  Thirdly, you can sit next to a woman who has a newborn and ask her all of those questions about being a new mom that you have been dying to ask someone.  Last, but not least, you will feel an abundance of support for your desire to breastfeed and know that this is a safe and fun place to return to after your baby is born.
6. Come up with a ‘Visitor Policy’.  Those first few days after your baby is born are critical in establishing your milk supply and helping your baby become a successful breastfeeder.   When the entire family and neighborhood are camping out in your hospital room, it might be difficult to feel entirely comfortable taking your top off and letting your baby find his/her way to your breast.  This is YOUR time to figure out breastfeeding, not to practice breastfeeding in front of an audience.  So, decide on a policy with your partner and stick to it.  Remember, your friends should understand that this is your time to get to know your baby and that they can all come and see you once you get home.
7. Choose a breastfeeding-friendly pediatrician.  The is most likely a physician you will see more in these next few year than any other you have ever seen before.  Make sure that the pediatrician is supportive and knowledgeable about breastfeeding.   Ask to interview him/her BEFORE your baby is born so that you can make an informed decision.
8. Create a hospital-plan that will optimize your breastfeeding success.  Items to include are: rooming in, no pacifier or bottles, no formula unless medically necessary, limiting visitors, delaying your baby’s bath, and keeping your baby skin to skin as much as possible.
9. Ask for assistance from a certified lactation consultant, or a well-trained postpartum nurse, while at the hospital.  Have her check positioning and your baby’s latch.  You are paying for these services, so  take advantage of them!
10. Look for a local lactation consultant while you are still pregnant.  Spend time perusing the Internet to find a local IBCLC that seems like a good fit for you.  Attach her name and contact information to your fridge, so you can find it quickly if you need it.  This way you aren’t calling the first person you find, out of desperation, after the baby is born.

*** I know I said Top 10, but I couldn't forget to include this tip.... Hire a birth doula.  The easier your birth is and the fewer birth interventions you encounter can definitely get breastfeeding off to a great start.  Doulas can make this happen:)

For more tips for preparing for breastfeeding before your baby is born, check out our interview with Ina May Gaskin for The Boob Group online radio show.

Thanks for your question, Jenny!  Hope this helps!

Warmly,

SDBFC