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Monday, February 19, 2018

Breastfeeding duration depends on preparation

Concerns about breastfeeding during the first 14 days after delivery can impact how long a new mother is likely to breastfeed, according to a study in the October 2013 issue of Pediatrics, the journal of the American Academy of Pediatrics (AAP).

breastfeeding, Colorado Department of Public Health

Courtesy Colorado Department of Public Health

Study authors interviewed first-time moms during pregnancy, 24 hours after giving birth and then periodically for the next two months postpartum. They found that mothers who expressed concerns about breastfeeding were at increased risk of ending breastfeeding and beginning the use of formula.

The most predominant concerns? Moms who found infant feeding at the breast to be difficult (52 percent), followed by those who experienced breastfeeding pain (44 percent) and moms who worried about how much milk they were making (40 percent).

The authors concluded that future efforts to increase breastfeeding duration should focus on protective factors—such as confidence in successful breastfeeding and adequate support—and resolving concerns as early as possible.

Protective factors include engaging support from key family members—a spouse or a partner, mothers, mothers-in-law and others who are apt to be around during those first few weeks, says Laurie Jones, MD, IBCLC, a pediatrician and lactation consultant at St. Joseph’s Pediatrics at St. Joseph’s Hospital and Medical Center

Delivering at a hospital that has full-time coverage with an IBCLC, or International Board Certified Lactation Consultant, is another factor that can make a difference in getting breastfeeding off to a good start, says Jones. Also, make sure to have a plan in place on where to follow up for outpatient lactation appointments after the baby is born.

Preparing in advance is a great way to bolster breastfeeding confidence. Jones, a member of the AAP’s Arizona chapter (AzAAP), shares a few tips to help get things off to a great start:

While you are expecting:

Take a prenatal breastfeeding class. Typically, the expectant mom focuses all her energy on the actual delivery and assumes that the breastfeeding part will go smoothly because it’s “natural.” Preparation for breastfeeding is just as important as preparation for the delivery.

Look for classes at the hospital or birth center where you will deliver. Most hospitals in Arizona offer a variety of prenatal classes on labor, baby care and breastfeeding. Bring important people with you to the breastfeeding class (partner, mother, husband, mother-in-law). The cost is typically around $25; some classes are free. Be wary of classes taught by a company selling products.

Choose health care providers that support and promote breastfeeding for your delivery and newborn visits.

Interview pediatricians before the baby is born to find out if they support breastfeeding.

Attend a LaLeche League meeting while pregnant. It helps to meet and talk to other moms who are making breastfeeding work in their lives.

If you qualify, meet with a Women, Infants & Children (WIC) breastfeeding peer counselor while you are pregnant and find out about their outpatient lactation support services.

Find out what services are covered by your health insurance plan: hospital-grade pump rental, personal pump for return to work, lactation consults, etc.

Use the Find a Lactation Consultant zip code search engine to find several IBCLCs that you can call for help.

If you have a history of breast surgeries or are taking long-term prescription medications, arrange to meet prenatally with an IBCLC to discuss the possible impact on breastfeeding.

Once the baby is born:

If breastfeeding hurts, GET HELP as fast as possible! Use the 24-hour Arizona Breastfeeding Hotline: 800-833-4642. You may need in-person help from an IBCLC.

Download a free, simple-to-use breastfeeding log or buy a phone app to track the number of baby’s feedings and wet/soiled diapers. It is a great way to confirm that the baby is getting enough milk.

Believe in yourself and your ability to breastfeed. There is just a very small percentage of mothers who do not make enough milk for their babies.

Do not keep free formula samples in the house for “just in case.” If there is a medical reason to use formula, it is widely available at every grocery store and drug store. If you have free samples in your house, you will be tempted to use them without a medical indication. Early use of formula without a medical indication will lead to low milk supply.

Read more about breastfeeding.


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Vicki Louk Balint

Multimedia journalist Vicki Balint covers health topics for RAISING ARIZONA KIDS.

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