How Do I Prepare to Breastfeed?

QUESTION:  I am seven months pregnant with my third child.  I had trouble feeding my other two children. What could I do now before the baby arrives so I will be able to breastfeed this child?

First, it would be helpful to know a little more information so that I understand the problem you had with your other two children.  Statistically, the most common problem associated with breastfeeding is inadequate milk production.  But, I have a myriad of other question in the back of my mind.  How soon after you gave birth did you put the baby at your breast?  Were you able to achieve a good latch on?  How frequently did you nurse in the first two to three days?

Let me guess that the breastfeeding trouble you experienced was inadequate milk production.  This is the most common reason that women give for prematurely discontinuing breastfeeding.  There are many reasons that can lead to this. I like to conceptualize problems with inadequate milk supply in three categories.  The first category is problems that could occur which you might consider "pre-glandular", such as hormonal problems.  A good example would be retained placenta.  Here the placenta produces progesterone that inhibits prolactin.  The second category of problems is "glandular".  Examples in this category would include mastitis, breast surgery, or insufficient glandular tissue.  But the last category, "post-glandular", is the most common.  Within the last category (post-glandular) lie the most common and preventable causes for inadequate production.  Basically, these include any situations resulting in infrequent or ineffective milk removal, beginning from the first day postpartum.

Assuming that your problem was in this category, the best scenario for you and your new baby would be to begin nursing as soon as possible after delivery.  But, in addition to nursing your baby, you should ask the lactation consultant at the hospital to provide you with an good electric pump (the Medela Classic, for example, not the Lactina).  Pretend this ugly contraption is your twin.  Make sure that at least eight times a day (six times during the day and two times at night) you effectively stimulate your breasts (breastfeed followed by pumping).

I also suggest that when you nurse your baby, you try to avoid distracting influences.  As much as possible, nurse by yourself.  Have all of the people that love you take care of your home, meals, and your other two children.  Protect the first two weeks with your new baby as much as possible.  If this doesn't result in an adequate supply, I would strongly suspect that there may be a more difficult to diagnose, yet less likely condition that might be impossible to reverse.  Hope this is not the case.  Best of luck!

Dr. Jane Morton, Clinical Professor of Pediatrics at Stanford University School of Medicine, is an expert on nursing premature infants as well as a member of the Breastfeeding.com medical advisory board. Dr. Morton has answered several of your breastfeeding questions.  Look for more Q&A forums with Dr. Morton in the future.

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