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You can do a great deal during pregnancy to prepare for breastfeeding.
First and foremost, look after your health and eat a well balanced diet so you feel at your best and your baby gets a good start. You may want to learn about breastfeeding, discuss it with your partner, and find out who will be able to help if you have any difficulties.
You don't have to store fat in pregnancy to be able to breastfeed. If you don't lay down much extra fat, all you need to do when breastfeeding is to eat more; millions of women in developing countries lay down no fat in pregnancy, yet breastfeed successfully for very long periods if they have enough to eat.
If you are planning on having your baby in hospital then try to find out if the hospital has Baby Friendly Status. Baby Friendly Hospitals use 'Ten Steps to Successful Breastfeeding'. This means they:
1. Have a written breastfeeding policy that is routinely communicated to all health staff.
2. Train all health care staff in the skills necessary to implement this policy.
3. Inform all pregnant women about the benefits and management of breastfeeding.
4. Help mothers initiate breastfeeding within half an hour of birth.
5. Show mothers how to breastfeed and how to maintain lactation even if they are separated from their infants.
6. Give newborn infants no food or drink other than breast milk, unless medically indicated.
7. Practise rooming-in (allow mothers and infants to remain together) 24 hours a day.
8. Encourage breastfeeding on demand.
9. Give no artificial teats or pacifiers (dummies or soothers) to breastfeeding infants.
10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
Make A Birth PlanIt's a good idea to make a Birth Plan. For example, you might say you would like to hold your newborn baby immediately after birth and to offer the first feed when the baby is ready. You might want to point out that you want your baby to have only breast milk and not be given bottles without your personal permission.
Women who leave hospital within 48 hours are more likely to breastfeed successfully than those who stay in longer. This is scarcely surprising as most of us relax better in our own environment and therefore produce more milk and let it down more reliably. Also the loving, emotional support and encouragement you need can best be supplied by family and friends.
Talk with your partner about the advantages of breastfeeding and what it will mean to him. He'll probably be pleased to support your decision to breastfeed, especially once he understands how important breastfeeding is and how valuable he can be as protector and encourager. Researchers say the partner's attitude is the single most important influence on a woman's decision on how to feed her baby. Partners of women who plan to bottle-feed usually don't know about the health benefits of breastfeeding; they also tend to imagine, mistakenly, that breastfeeding makes a woman's breasts sag (which isn't true, provided you give your breasts adequate support) and will spoil their sex life (though fatigue is a far more common culprit after childbirth).
Find out as much as you can about breastfeeding before you start as if you understand how breastfeeding works, you'll be aware of what might happen and know when to get help for any problems.
Try and find numbers of local breastfeeding support groups so that you have them to hand after the birth.The National Childbirth Trust (NCT) have good breastfeeding counsellors who are well trained in helping with breastfeeding problems on a mother-to-mother basis, and have breastfed babies themselves. La Leche League International (LLLI) is a worldwide organisation of women who are breastfeeding or who have breastfed and want to encourage and help each other with breastfeeding.
You'll need several bras when breastfeeding, because they'll require frequent washing, especially early on when you're bound to leak. If you buy a nursing bra, note that they can have drop-down cups or zipped cups. Drop-down cups are easiest to use. Choose bras no earlier than around 36 weeks of pregnancy, or if possible wait until after your baby is born, so they fit well.
Pregnancy is a time to be especially careful about looking after your breasts. It's sensible to wear a bra in bed during the last three months of pregnancy to support your increasingly heavy breasts and help prevent your skin stretching. Maternity bras sold as sleep bras are usually too insubstantial to provide much support.
Good clothes to have ready for breastfeeding include loose T-shirts, sweat-shirts, jumpers, blouses and almost anything you can pull up from the waist. These make for easy breastfeeding and allow you to feed without showing everything. Indeed, feeding a baby with your top pulled up just enough looks as though you're simply having a cuddle, which makes it easy to feed in public.
Think too about where you'll sit to breastfeed, since a comfortable place will help you relax and so reduce the risk of aching shoulders and arms after a feed. A good nursing chair is low, so your lap is flat enough to support the baby well, and has arms or a place to put cushions to support your elbows at the right height. A rocking chair can be pleasant and many women are comfortable sitting on a sofa or bed with their feet up. Lying down to feed is most relaxing of all. A nursing pillow is also invaluable.
Breast & Nipple CareThere's no convincing evidence that any ante-natal preparation - such as rolling nipples, rubbing them with a rough towel, putting on lanolin, cream or alcohol, and expressing colostrum - makes breastfeeding any more successful than doing nothing at all.
Some nipples are flat or inverted (turned inwards) but if your nipples usually come out when you feel cold or sexually aroused, then you shouldn't have a problem. Between 7 and 10% of pregnant women who want to breastfeed have truly inverted nipples (which won't come out at all) or poorly protractile nipples (which don't come out much). The good news is that nipple shape and protractility often improve in pregnancy. However, many women with nipples like this manage perfectly well, especially if a skilled carer helps them position their babies and reminds them not to limit the number or length of breastfeeds, or give bottles of formula.
If you still have inverted nipples at the end of pregnancy your baby may still be able to suck efficiently if you 'make a biscuit' of your areola and nipple with your thumb and forefinger and offer it to him. Engorgement is the number one enemy of successful latching-on in women with inverted nipples, so avoid this at all costs.
Tiny protruberances around the areola called Montgomery's tubercles produce an oily fluid which keeps the areola and nipple supple and kills bacteria. If you wash this away with soap, your skin is much more likely to become sore when you breastfeed. So avoid soap for the last few weeks of pregnancy and just wash your nipples with warm water. There's no need to use any ointment or cream to prepare for breastfeeding, because nature's own lubrication is best. Similarly, there's no need to remove the yellowish grains of dried secretions you may see on your nipples - a simple water splash is enough.
With everything prepared for breastfeeding you can concentrate on looking forward to your baby's birth.
Dr. Penny Stanway
You can buy Dr. Stanway's book 'Breast is Best' here