LivingHow to prepare for successful breastfeeding from pregnancy

How to prepare for successful breastfeeding from pregnancy

Breastfeeding has many benefits for both mother and baby. In fact, the WHO recommends that babies be exclusively breastfed for up to six months.

However, although most women want to breastfeed and breastfeed their newborns initially, many have difficulties and the rates of exclusive breastfeeding at six months are far from desirable. Is there anything we can do right from the pregnancy to have a successful breastfeeding?

The breast changes during pregnancy

The breast undergoes changes during pregnancy to be ready to breastfeed when the time comes. The mammary gland, responsible for producing milk, has just completed its maturation during pregnancy.

The breast increases a lot in size and the areola darkens; This color change will help the newborn to better locate the nipple (remember that the newborn’s vision is very immature). In addition, from the second half of pregnancy, colostrum begins to be produced, greatly increasing its production towards the end of pregnancy and during delivery. That is, all mothers have colostrum when the baby is born.

Information is power

About the only thing I recommend to pregnant mothers when preparing for breastfeeding is to educate themselves. And it is that breastfeeding training has been shown to increase the prevalence and duration of breastfeeding . In 2004 two Spanish authors, Balaguer and Aparicio, carried out a study with 450 pregnant women who wanted to breastfeed their babies. They divided them into three groups: in the first, women would receive standard preparation for delivery, in the second they would also receive a specific class on prenatal breastfeeding, and in the third they would receive 2 specific classes on postnatal breastfeeding. It was observed that, in both the second and third groups, the breastfeeding figures at 6 weeks, 3 months and 6 months were higher than those of the first group.

We can also find an extensive review of 7 articles in which it was found that breastfeeding education is an effective measure to increase breastfeeding initiation rates .

Is it necessary to prepare flat nipples for breastfeeding?

Many mothers come to the consultation concerned because they think that with their flat nipple they will have problems breastfeeding and, unfortunately, many professionals believe that flat nipples are not appropriate for breastfeeding. The only type of nipple that can cause difficulty or even inability to breastfeed is a true inverted nipple , in which the fibers that make the nipple protrude are very short or non-existent. The rest of the nipples (flat, false inverted, large, small …) are perfectly suitable for breastfeeding. If we can make skin to skin after delivery and our baby suckles in the first hour of life, that first spontaneous latch on will generate an imprint and promote breastfeeding.

As the issue of flat or inverted nipples and breastfeeding has been a concern over the years, various prenatal techniques and treatments have been explored to make them protrude. Nipple-forming shields, Hoffman exercises (consisting of performing certain nipple movements several times a day), rubber bands, use of syringes, and even marital suction have been studied. Although these are low-quality studies, none of these treatments appear to make breastfeeding more successful than if they were not.

So, if a woman has flat nipples, the best thing she can do is try to make skin-to-skin immediately after delivery (whenever possible) and favor that first spontaneous latch on; If your baby can’t do it on his own, you can seek help from a trained breastfeeding professional. However, the nipple tends to protrude more as breastfeeding progresses.

Prenatal extraction of colostrum

We have commented that colostrum begins to be produced already during pregnancy. Through the prenatal extraction of colostrum it is intended to make a small “colostrum bank” the weeks before delivery so that, if our newborn needs supplements or the mother cannot be with him during the first hours, he can take that extracted colostrum During pregnancy.

This has been widely studied in mothers with diabetes, but it could also be useful in some situations in which mother-child separation or low milk production is anticipated: women with breast hypoplasia, with polycystic ovary syndrome (some women with this syndrome have difficulties breastfeeding); CIR (retarded intrauterine growth) babies, in whom a low birth weight is estimated or with any malformation that may make feeding difficult; or scheduled cesarean sections or maternal illnesses in which it is believed that mother and baby will not be able to be together during the first hours after birth.

With the manual extraction of colostrum, oxytocin is released (as during sexual intercourse or if we breastfeed another baby during pregnancy, for example), so some professionals wonder if there could be a risk of premature birth. The latest studies indicate that it is a safe technique in low-risk pregnancies and can bring many benefits. In addition, it usually begins to perform around week 36 or 37 of pregnancy. It is important that the prenatal extraction of colostrum be guided by a healthcare professional and stopped if pain or contractions develop .

What do I need to buy if I want to breastfeed?

When they ask me this in the query my initial answer is usually: “nothing!”; but the truth is that there are some things that can be useful. Nursing bras are essential (although it is likely that the first days after delivery, due to the sensitivity of the nipples and the swelling of the breast, we prefer not to wear anything). I also recommend having clothes suitable for breastfeeding , specially designed for this purpose or that facilitate access to the chest, for example a shirt or dress with front buttons; Newborns initially take between 8 and 12 feedings a day, so it is good that the breast is accessible. It is common for the breast to leak milk, especially the first few weeks (for some women it happens throughout breastfeeding and for some never). To do this, it is good to carry discs inside the bra (they can be disposable or reusable fabric).

Regarding the breast pump , it is not usually necessary at first. If you need because the baby gains little weight and it is necessary to supplement it, or because the chest is very full and the baby cannot latch on, you can do it manually; in fact, ideally, all women should be taught to perform manual expression postpartum . Only in some special situations, such as premature babies who need to be admitted or sick babies who cannot eat for the first few days, can a breast pump be recommended.

In summary then, most women do not need to do any breast preparation during pregnancy for breastfeeding . It is useful to receive a specific breastfeeding class or course prior to delivery . It is also advisable to buy some clothing suitable for breastfeeding.

In the case of being diabetic, if we foresee that there may be difficulties in breastfeeding (mammary hypoplasia, polycystic ovary), if it is likely that we will have to be separated from the baby for the first hours of life or if our baby is CIR, we can consult with our gynecologist or midwife to perform prenatal colostrum extraction.

In Babies and more | This is how breasts change in pregnancy: how to take care of them and avoid discomfort

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