Rebekah Mustaleski, CPM

Babies are born with instincts and reflexes that help them initiate breastfeeding. A delay in letting them use these natural abilities can hinder their effectiveness. For these reasons, you'll want to address the following topics in your birth plan. 

If you're getting closer to your estimated due date and you’ve started to put together your birth plan, then you know there is certainly a lot to consider! It’s a good idea for all pregnant women to spend some time looking through the options that are available during birth and writing them down. If you're planning to breastfeed your baby, you definitely need a section for that on your birth plan. The first couple of hours after birth have an enormous impact on successful breastfeeding and it also helps create an adequate breast milk supply.

Spending the first hours skin to skin is important for both mom and baby. Moms report less stress and greater breastfeeding satisfaction when they’re able to keep the baby on their chest with no clothes or blankets in between them. Babies who are placed directly on their mother's skin immediately after delivery are more likely to effectively nurse the first time, have better cardio-respiratory stability, more stable blood glucose levels, and increased breastfeeding success even up to 4 months postpartum.

If you're unable to provide your newborn baby with skin-to-skin care immediately after delivery or even in the early days postpartum, having your baby placed skin to skin with your partner is a good alternative.

If your baby needs to be separated from you, you’ll still need to work on establishing an adequate milk supply and hand expression is usually the most effective way to remove colostrum in the first 24 hours. After the first day, you can start incorporating a breast pump. Aim to pump or hand express for 8 to 12 sessions a day.

If you are giving birth in the hospital, you can request a hospital-grade pump to use while you are there. Most hospitals have a lactation consultant or IBCLC on staff who can help you figure out hand expression and how to use a pump. Early and frequent stimulation of the breast will help create enough milk for your baby and hopefully avoid some of the breastfeeding challenges that can occur when breastfeeding moms and their newborn baby are separated.

If you are using your own pump to encourage milk production or prevent engorgement, you’ll want to make sure that the flange of the pump fits your breast size. The important part to pay attention to is how your nipple, not the whole areola fits into the flange. The sides of the nipple should just fit into it, without rubbing on the sides or you will have sore nipples from the friction caused by pumping.

Once you have gone home, you can contact a lactation consultant or your local La Leche League support group for more help and information about how your baby latches, breastfeeding positions, breast milk supply, and any other breastfeeding-related questions you may have.

If you have inverted nipples, use a pump to pull the nipple out before helping your baby latch. This will aid breastfeeding mothers in achieving a good latch in the first couple of weeks postpartum. A new mom can struggle to get a deep latch, especially when everyone is tired, so having a pump nearby can set them up for increased breastfeeding success.

Bottle feeding and using a pacifier for comfort can create unnecessary breastfeeding issues, so it's important for you to make an informed decision about this before giving them to your baby. Ask your provider to get your permission before giving any supplements or pacifiers to your baby. Hand-expressed colostrum or formula can be fed to baby with cup feeding, syringe feeding, or with a supplemental nursing system without impacting your baby’s latch, as bottles tend to do. 

As part of your birth plan, have a list of support people that you want to use in the event that you need help getting started with breastfeeding. Studies have shown that meeting with a lactation consultant or breastfeeding counselor improves breastfeeding rates and the rates of exclusive breastfeeding, so don't hesitate to make the most of these resources. You may have a local La Leche League support group in your area, too. These groups tend to meet once or twice a month and most group leaders are available for questions that come up between meetings. I have worked with many breastfeeding moms who believe their La Leche League group saved their breastfeeding relationship!

A birth plan can be a useful tool in letting your healthcare providers know what your preferences are concerning the delivery of your baby. No matter how you put your plan together, make sure you include information about how you plan to feed your baby! And if you are planning to deliver your baby at the hospital or a birthing center, include nursing bras and a nursing pillow to your packing list.

References

N;, Moore ER;Bergman N;Anderson GC;Medley. “Early Skin-to-Skin Contact for Mothers and Their Healthy Newborn Infants.” The Cochrane Database of Systematic Reviews, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/27885658/.

EM;, Gray L;Miller LW;Philipp BL;Blass. “Breastfeeding Is Analgesic in Healthy Newborns.” Pediatrics, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/11927701/.

S;, Patel S;Patel. “The Effectiveness of Lactation Consultants and Lactation Counselors on Breastfeeding Outcomes.” Journal of Human Lactation : Official Journal of International Lactation Consultant Association, U.S. National Library of Medicine, https://pubmed.ncbi.nlm.nih.gov/26644419/

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