The word is out! Most expectant parents today are well informed about the compelling health benefits of breastfeeding for infants and mothers. Three-quarters of U.S. mothers now begin breastfeeding their newborns--a stark contrast from the 20% who did so when my own first baby was born. While breastfeeding information and support have increased dramatically in recent decades, many new mothers encounter lactation challenges that prevent them from reaching their personal breastfeeding goals. One of the most helpful steps an expectant mom can take to set the stage for long-term breastfeeding success is to prepare ahead for an optimum breastfeeding experience in the hospital.
A recent large study in Colorado has identified five supportive maternity practices that have a significant positive impact on breastfeeding duration among mothers of healthy newborns. To get the best possible start with breastfeeding, enlist the support of your partner and family and ask your health-care providers and the hospital nursing staff to help ensure that you experience the following five breastfeeding-friendly maternity practices:
1. Your baby is breastfed in the first hour after birth.
Early breastfeeding begins with immediate skin-to-skin contact with your baby after birth. Essential skin-to-skin contact not only eases your baby’s adaptation to the world, it stabilizes his heart rate and breathing, keeps him warm and calm, helps maintain his blood sugar level, and allows the two of you to get to know one another. Ask to have your baby placed tummy down on your bare chest immediately after delivery, and watch how his inborn reflexes help him achieve a successful early feeding. You will want to limit your visitors during this intimate bonding time that makes your birthing experience even more memorable and special. Forewarn excited family members that prolonged skin-to-skin contact is essential for your baby to reduce the stress of birth and establish breastfeeding. Their turn to hold and cuddle the new family member will come later on. A baby who nurses well shortly after birth is more likely to continue breastfeeding effectively, and a successful early first breastfeeding experience increases your confidence.
2. Your baby stays in the same room with you.
By keeping your baby in your room throughout your hospital stay, you can continue to provide skin-to-skin contact, learn to recognize her earliest feeding, cues, and offer your breast whenever your baby is ready to nurse. Studies show that babies are less stressed and do not cry as much when they are cared for in their mother’s room. When you provide most of your baby’s care yourself in the hospital, you leave knowing that you will be able to meet your baby’s needs at home. To make the most of your rooming-in experience, ask your partner to help limit your visitors at the hospital and monitor their length of stay. Having your family and friends celebrate your new baby’s arrival can be fun for a time. However, too many visitors and frequent interruptions can compete with your breastfeeding priority. Furthermore, interacting with a steady stream of guests shortly after giving birth can leave you too depleted to feel up to caring for your baby at night.
3. Your baby is fed only breast milk in the hospital.
Many studies show that breastfeeding exclusively in the hospital is linked with a longer duration of breastfeeding. The early milk your breasts produce in small quantities, known as colostrum, is the perfect first food for your newborn. Ordinarily, frequent, round-the-clock breastfeeding will provide all the milk your healthy baby requires. Supplemental milk should be offered only for a valid medical reason. If your baby has a medical need for supplemental milk, attempt to express some of your own breastmilk and offer it by spoon or cup, instead of giving formula in a bottle. Early bottle-feeding can make it more difficult for your baby to learn to breastfeed effectively. Breastfeeding your baby exclusively, round-the-clock, whenever he gives feeding cues is much easier when you limit your number of visitors.
4. Your baby does not use a pacifier in the hospital.
Several studies have found an increased risk of early weaning when a pacifier is introduced to breastfed infants in the first weeks of life. During this sensitive time, all your baby’s sucking efforts should help her perfect her breastfeeding technique, provide her with the milk she needs, and stimulate your breasts to produce a generous milk supply. Once breastfeeding is going well and your baby is thriving, you can offer her a pacifier if you desire. Because several studies have found a strong protective effect of pacifiers on the incidence of Sudden Infant Death Syndrome, the AAP recommends that babies use a pacifier when falling asleep. Mothers of breastfed infants can wait several weeks to a month to introduce a pacifier.
5. The hospital gives you a phone number to call for breastfeeding help after discharge.
These days, new mothers typically are discharged from the hospital before their milk has come in and before their baby has become proficient at breastfeeding. Even when breastfeeding seems to be going well in the hospital, problems may arise in the early days at home. Knowing where to turn for help can allow you to overcome early breastfeeding glitches before you become discouraged. There’s no need to struggle on your own. All breastfeeding questions are important, and expert advice is available. Ask your hospital nurse or lactation consultant who to call for breastfeeding help after you go home. Many hospitals now offer invaluable follow-up breastfeeding services—including support groups and individualized help--for their new mothers. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) offers breastfeeding education, peer counselors, and breast pumps for their nursing clients.
Arriving at the hospital prepared to experience these five supportive breastfeeding practices will boost your chances of a successful and satisfying breastfeeding experience after you go home!
Dr. Neifert is the author of "Great Expectations: The Essential Guide to Breastfeeding."