Prior our move to the VA mountains I had the privilege of earning my Certified Lactation Counselor credential and working with breastfeeding mama's for 2 years through our local WIC office. I was invited into the early moments of many birth days for people in our community. It was a very unique experience I am so grateful for! In those months of conversation prior to baby's birth many soon to be Mama's would come to my office with lists of questions.
Without doubt they would always ask about milk supply. Whether they had heard a horror story from a friend, been told by their own mother they had been bottle fed due to low milk supply or had read an article on the internet, low milk supply was a major concern. Thankfully for most women, it is easy to establish a healthy milk supply can be achieved with a few strategic choices prior to delivery, in the hospital and upon discharge.
Simple Ways to Establish a Healthy Milk Supply
My first suggestion to you would be to consider the hospital you are choosing. Hospitals have been encouraged by the World Health Organization to work towards becoming Baby Friendly. This term involves a 10 step process and standards that emphasize breastfeeding over bottle feeding on the maternity ward. As a CLC I worked with clients who were working towards Baby Friendly status and those who did not. Their experiences were very different.
Another step you can take prior to delivery is to connect with your local LaLeche League, WIC office Breastfeeing Peer Counselor or Breastfeeding Support Group. Attend meetings, hear from other women and connect with the leaders.
Whether you are in a Baby Friendly hospital or not you can still make a few simple requests to help you have a smoother start.
When you are admitted, inform the nursing staff that you would like to have a consultation with a Lactation Consultation prior to discharge. If you have found a CLC or IBCLC that you feel supported by, give the name and number to the nurse and request they be contacted after the birth. Second, request that no formula be brought into the room, or given to the baby unless it is a life threatening necessity prescribed by the pediatrician. Third, tell everyone who is around you in your support circle to help advocate for you to breastfeed. Finally, if you have not heard from your lactation support within 24 hours of birth contact them yourselves.
After a vaginal delivery it has become standard practice to allow for skin-to-skin time for mother and baby. Nurses are generally very concerned to get the child's weight and apgar score, but even with these quick tests you can still have a good amount of time with your new little one while they are awake. Babies are most alert just after birth for about an hour. It is at this time that an initial attempt at breastfeeding should occur.
Breastfeeding will help contract the uterus which is very helpful for Mama right after birth. Do not rush this time. Let baby suck and rest, suck and rest. They will only take in about a tablespoon of colostrum at most. This is PERFECTLY FINE. Babies have very tiny tummies and colostrum is megapacked with antibodies the baby needs to protect them. From this initial time of nursing you will need to attempt nursing every 2 hours until the milk supply is established.
Baby will be tired (it's been a big day!) and may not want to suck for long. Generally I would tell my Mama's to try for 15 minutes on each breast. If baby is to sleepy this is a perfect time for some more skin-to-skin loving. Having baby on your chest will regulate heartbeat, oxygen and often body temperature. It will also help you begin to identify hunger cues.
The reason that attempting breastfeeding about every 2 hours at this point is that breastmilk is established by stimulation. The more your body is stimulated the more milk it will produce. Another thing that will help is hearing your baby cry. Isn't it amazing to consider how every part of how Mama and baby were created show they are made to be a team? Troubleshooting like assessing latch, tongue tie, or waking a very sleepy baby can all be done by a nurse or Lactation Consultant.
Because you are having to wake to breastfeed so often it is very important that you limit hospital visits, eat well and keep hydrated. These steps will help you get more sleep. Remember, this is a short sacrifice for a long term routine. Soon enough your little one will stretch feedings and you will be getting more sleep. Once you arrive home visitors will show up. Take advantage of meals being offered and don't hesitate to ask someone to run a vacuum, throw a load of clothes in the wash or wipe down the kitchen. Remember, you are feeding and caring for 2 people now, help will be necessary. Set an alarm on your phone and keep the 2 hour schedule going. If baby is nursing well you may find that 2 ½ -3 hours is a better routine. Going longer then 3 hours between feedings at this point WILL hinder milk supply. Weight checks can be done at the doctor's office, hospital or WIC office. It will be desired by most doctors that baby is back to birth weight or close within a week of delivery.
A Few Things to Remember
-When your baby cries they are telling you they need you. It might not always be that they are hungry, but in the first 6 weeks or hunger cues are clear, always offer the breast.
-Humans do not eat the exact same amount of food at the exact same time every day. You may find some days that baby is alert and hungrier then others.
-Your only job until your milk is established is to care for youself and baby, there is plenty of time for everything else. (This too shall pass)
-Pumping and offering a bottle “so you can get some sleep or take a break” as is often suggested will hinder milk supply in the beginning weeks. If you are not stimulating your breasts every 2-3 hours your body will not produce enough milk.
-Being properly hydrated and fed is vital to milk production. Breastfeeding burns several hundred calories a day. If you are not well nourished your body may stop producing milk for survival.
-Birth control and other medicines can hinder milk supply. Always consult your doctor AND lactation support prior to taking medicine.
-Skin-to-skin is comforting and helpful for both mom and baby. You cannot spoil a baby in the first 6 weeks of life!
-The United States is the only country in the world where formula feeding is as common as breastfeeding. You are not alone in your breastfeeding journey even if every Mama around you seems to prefer bottle feeding.
What breastfeeding advise would you give a mama who has decided she wants to breastfeed but doesn't know where to start?
Beth Walker blogs at http://lessonsfromthesidelines.wordpress.com where she reflects on being a coach's wife, mother and what Jesus is teaching her.
READ MORE: 10 Things All Breastfeeding Moms Need