Breastfeeding is natural, but that doesn’t mean it comes naturally. While babies are born with the reflexes and instincts to nurse, sometimes challenges arise. Without proper education and support, breastfeeding mothers may discontinue breastfeeding earlier than they had intended to. In fact, 83% of families initiate breastfeeding and less than 25% continue to exclusively breastfeed at 6 months postpartum. Knowing the common barriers to breastfeeding and things you can do to prepare for breastfeeding before your baby arrives can help set you up for success.
Barriers to Breastfeeding
Sixty percent of women do not breastfeed for as long as they intend to. Some common reasons reported for discontinuing breastfeeding early include:
- Lack of breastfeeding knowledge and skills.
- Cultural norms (i.e. bottle feeding is viewed as the “norm” in the US).
- Lack of social support and negative attitudes toward breastfeeding.
- Embarrassed to directly nurse in public.
- Lactation problems (i.e. nipple soreness, engorged breasts, and leaking milk).
- Latching issues.
- Lack of maternity leave.
- Unsupportive healthcare providers and hospital practices.
Five Things to help you Prepare
1) Take a breastfeeding course
For most people, their first real life experience with breastfeeding is after their baby is born and they are expected to just know how to do it. Knowledge is power when it comes to preparing to breastfeed, so take the time prior to giving birth to go through a course and learn: how your breasts produce milk, normal newborn behavior, different latching techniques, breastfeeding positions, and how to know if your baby is getting enough milk so you can feel confident once your baby arrives. Trust me, if you’ve just given birth and you’re sleep deprived and exhausted, your ability to concentrate, focus, and retain new information is going to be much more challenging! Taking a course during your third trimester, before your baby’s birthday, will help alleviate stress for both you and your baby. If possible, invite your support person (partner, family member, friend, etc.) to join you at your breastfeeding course so they can get a better understanding of your breastfeeding goals and learn different ways they can help.
If you’re looking for a breastfeeding course:
- Check with your insurance to see if they have any resources available to you
- In person classes in your area
- Check with your local hospital
- Ask your healthcare provider
- Google “breastfeeding courses in (your city)”
- Online courses
- Google “breastfeeding courses”
2) Book a prenatal lactation appointment
Check with your insurance to see what lactation services are covered. Meeting with an International Board Certified Lactation Consultant (IBCLC) during pregnancy can help you create a breastfeeding plan so that you, your support system, and your care team know what your feeding goals are. This is also an opportunity to learn the basics of breastfeeding, get any questions answered, and come up with a plan for your individual circumstances.
3) Obtain your insurance covered breast pump
Under the Affordable Care Act, ACA, health insurance companies in the US are required to cover the cost of breastfeeding equipment and comprehensive lactation support services while pregnant and after you’ve given birth. Breastfeeding equipment includes a double electric breast pump (including pump parts and maintenance) as well as breast milk storage supplies. When you’re ready to select your pump, contact your health insurance company because they will likely have a specific durable medical equipment company they are contracted with that you can select your breast pump through. There are so many different breast pumps on the market today, and meeting with an IBCLC prior to selecting your pump can help narrow down the best pump options and flange size for you.
4) Helpful products
If you’ve strolled down the baby aisle at Target or registered for items for your baby shower, you have probably seen all of the breastfeeding products on the market and wondered, “What do I actually need?” Don't fret, I’ve compiled a list of products I find helpful to have on hand immediately postpartum:
- nipple cream
- nursing and hands-free pumping bra (2-in-1)
- breastfeeding pillow
- nursing pads
- water bottle
After your baby is here, you will quickly figure out if there are any other items you need.
5) Learn hand expression
Hand expression is a really great tool to learn and can help protect your milk supply if breastfeeding challenges arise early on postpartum. Hand expression is using your hand to manually express milk out of your breasts. Your first milk, called colostrum, is really thick and sticky and hand expression tends to be more effective at removing milk in those early days postpartum compared to a breast pump. With your healthcare provider’s approval, you can even begin expressing your first milk and storing it to bring to the hospital with you as early as 36 weeks pregnant. There are many helpful videos you can reference online to learn how to hand express, but here are the basic steps:
- Position your hand in the shape of the letter C (similar to what you would be doing if you were grabbing a cup).
- Place your hand on your breast about 1-2” outside of your areola with your nipple positioned in between your pointer finger and thumb.
- Press back in toward your chest wall, roll your fingers together (like you’re giving your fingerprints), and relax.
- It may take a few compressions before you start to see milk moving.
- Rotate your hands around your breast and continue to press, compress, and relax.
- You can collect your milk by drawing it up with a syringe, expressing onto a spoon, or expressing into a medicine cup.
Breastfeeding can be challenging, and empowering yourself with the knowledge, skills, and support you need can make a world of difference when it comes to meeting your breastfeeding goals and overcoming any breastfeeding issues that arise. If you’re in the US your health insurance plan should cover the cost of a double electric breast pump, pump parts, and milk storage supplies as well as lactation support while you’re pregnant and postpartum. I highly encourage you to take advantage of these benefits and take a breastfeeding basics course, meet with an IBCLC prior to giving birth to talk through your questions and concerns, come up with a feeding plan, and have a breastfeeding specialist on speed dial for whatever comes up after your baby is here!
This site is intended for informational purposes only and does not provide medical advice. Please consult your physician or other health-care professional.