Breastfeeding: Get Off to a Good Start

Photo Credit: Dave Clubb via Unsplash

The benefits of breastfeeding, or providing breastmilk to your baby, are well known. Most of my clients intend to breastfeed for some length of time.

What I try to impart in prenatal discussions with clients, however, is that intention is usually not enough to get off to a good start with breastfeeding. Maximizing the breastfeeding relationship also involves education, planning, and knowing where to turn if difficulties arise.

1. Take a prenatal breastfeeding class. There is so much more to breastfeeding than putting baby to the breast. While breastfeeding is a natural process, that doesn’t mean it is necessarily intuitive, easy, or without complications.

​A good prenatal breastfeeding class should cover most of these topics:

• The bodily mechanics of breastfeeding, including the hormones involved, breast anatomy, and how breastmilk is produced and transferred
• The composition and benefits of breastmilk and breastfeeding
• Your baby’s dietary needs, from birth through the first few weeks or months
• Your baby’s hunger cues and feeding patterns
• How to establish a good latch and why this is important
• Different breastfeeding positions
• Your dietary needs and postpartum support
• How your partner can support and encourage breastfeeding
• Hand expression and pumping and when to start, and breastmilk storage guidelines
• Alternative ways to feed your baby
• When and why to supplement with formula or donor breastmilk
• Bottle feeding, including paced bottle feeding
• Complications that can interfere with breastfeeding such as tongue tie, Cesarean birth, premature birth, nipple pain, clogged ducts and mastitis, thrush and supply issues
• Local resources for breastfeeding support

While you may not retain or need all the information you learn in a prenatal breastfeeding class, you never know what important facts will be helpful as you learn to feed your baby. Misconceptions you may have had will be dispelled, enabling you to use the most accurate information to support your efforts.

Plus, it will be much easier to find the time and energy to learn about breastfeeding before your baby is born, rather than while you are recovering from birth and learning to feed your baby, all with limited sleep.


2. Get hands-on help with latch. A good, deep latch is one of the most important factors in establishing a good breastmilk supply. 

When your baby suckles at the breast, it signals to your body to produce the hormone prolactin, which stimulates the production of breastmilk. Oxytocin is also released, triggering the let-down reflex which expels the breastmilk from the milk ducts.

When the latch is shallow, or there is a problem with latching, this hormonal interplay is interfered with and over time, your milk supply and/or baby’s ability to transfer milk from the breast can be negatively affected.

​Most hospitals offer lactation support, sometimes immediately after birth and in postpartum recovery. Birth center and home birth midwives also help with breastfeeding and latch; during postpartum home visits, midwives assess baby’s weight gain and can make recommendations for additional lactation support if needed.

As a birth doula, I can help my clients with that initial breastfeeding right after baby is born, showing them the hallmarks of a good latch. Or, I can help them to facilitate baby latching on his or her own, either via a breast crawl or with a laid-back breastfeeding position. If there is separation from baby for a period of time, I can help them hand-express colostrum into a cup or syringe that can be given to their baby instead of formula, if that is their preference. 

And when I visit my clients at home, either at the follow-up postpartum visit or as a postpartum doula, we can continue to work on latch after their milk has come in, trying out different positions. If there are signs of a complication beyond my scope as a doula, I can refer them to a local lactation specialist for professional support and problem solving.

Getting frequent, hands-on help with latch can ease anxiety and frustration in the birthing person, possibly avoid supply issues and injury to the nipples, ease pain or discomfort during nursing, and make the experience more enjoyable.


3. Turn to the experts for help. Breastfeeding problems and solutions can be complex and can involve several factors, including breast anatomy, baby’s anatomy, diet and nutrition, hormones, birth influences, emotional and cultural considerations, the need for supplementation, and more. 

Sometimes, people get advice or help from family members or friends, or even professionals, including lactation consultants, pediatricians, and family doctors, that aren’t based on the latest research. Or the advice doesn’t take into account all of the factors mentioned above that can make breastfeeding issues challenging. They may not be familiar with alternatives or breastfeeding best practices. And they might not have the availability or resources to provide the frequent, hands-on help that nursing people often need.

When my clients need breastfeeding help beyond what I can provide, I refer them to the infant feeding experts: International Board Certified Lactation Consultants (IBCLC’s). The requirement to become an IBCLC includes extensive education, over 1,000 hours of clinical experience, and passing a rigorous exam. IBCLC’s know breastfeeding and can help you work through a myriad of problems, with solutions tailored to your individual needs and preferences.

See my Parent Resources page for some local IBCLC’s I know and trust.


4. Support for breastfeeding goes beyond actual breastfeeding. Knowing how to support breastfeeding and actually having the support you need to breastfeed are two different things.

When you are recovering from birth and learning to care for your new baby, it becomes much more difficult to learn to breastfeed when you also have to worry about preparing meals, keeping your house in order, caring for older kids, entertaining visitors, or “bouncing back” to a preconceived notion of how your life should look.

Anything that adds stress instead of reducing it can interfere with breastfeeding. Making a postpartum plan while you are pregnant, reframing in your mind for what the postpartum period should look like, and enlisting help wherever possible— whether that be from your partner, family and friends, outsourcing tasks, or a hiring a postpartum doula— are all ways to support breastfeeding.

5. Be gentle with yourself in your journey. Breastfeeding doesn’t always go as you plan. Sometimes you find that supplementation, or exclusively pumping, or formula feeding, or sourcing donor milk, or weaning, or some combination of these, is the best choice for you at any point in time.

Know that what works for you now may not be what works for you down the road. Know that if you struggle now, that doesn’t mean you will be struggling later. Know that if you hit a snag, there are people in the community who can help.

​And know that your mental and physical health matters. There is no “right” time to wean, except when you and/or your child are ready. Be gentle with yourself and allow yourself the grace to find your own way.

I am a certified birth doula, postpartum doula, and childbirth educator serving clients in Boise, Meridian, Eagle, Nampa, and the Greater Treasure Valley.
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