While breastfeeding comes easily to some mums and babies, many others need extra help. However, there’s lots you can do to prevent problems developing and get breastfeeding off to a good start.
Before your baby’s birth
test123 Attending an antenatal class is a good idea. You’ll learn how important skin-to-skin contact is in initiating your milk supply, and you’ll probably receive other breastfeeding advice too. Your course leader may give you a list of local lactation consultants, breastfeeding specialists, or support groups. If not, make a note of local experts and a breastfeeding helpline, and find out if any groups are held nearby.
Also remember to include breastfeeding and having early skin-to-skin contact with your baby in your birth plan. This will help ensure the healthcare professionals looking after you know your wishes.
Who can give breastfeeding support?
If you need help after your baby is born, seek advice straight away. A minor problem can worsen rapidly, but most issues are quick and simple to fix if caught early.
Healthcare professionals, such as midwives, nurses and doctors, often have standard training in breastfeeding support. If you have more complex needs it’s worth seeking professionals who’ve had additional training. These fall into two broad categories – breastfeeding specialists, which include peer supporters and counsellors, and lactation consultants:
Peer supporters or peer counsellors
These are mothers who breastfed their babies and are trained to help with everyday problems. They can tell you whether your baby is well latched on and taking in enough milk. If your baby isn’t latching well, they’ll be able to help you find a better way to position him. If they spot a problem they can’t help with, they will be able to refer you to someone who can.
Breastfeeding counsellors (such as La Leche League leaders) have a deeper level of knowledge and can help with many of the trickier problems, such as a baby who isn’t gaining sufficient weight or who is refusing to latch.
A lactation consultant is needed for more complex problems, such as diagnosing low milk supply and helping mums with premature babies. They have IBCLC after their name, which means they’re members of the International Board of Certified Lactation Consultants and have had extensive training – visit its website to check if someone is registered.
What problems can an expert help with?
Here are outlines of some of the most common breastfeeding problems, with links to further advice.
A baby who won’t latch
Ideally, your newborn will latch within the first few hours. If he doesn’t, or the latch is uncomfortable, a midwife or peer supporter can check it. Don’t be afraid to ask for his latch to be rechecked, even if it was done at your birth facility. If your baby is still not latching after 24 hours, and you’re no longer in your birthing unit, an IBCLC lactation consultant can offer further support. Read more on getting a good latch.
Almost always caused by your baby not being well latched, a peer supporter or counsellor can help you adjust his position. If the pain is severe or persistent, even after adjustments, an IBCLC lactation consultant can check for a cause that may have been missed before. Read more on sore nipples.
The best way to avoid engorgement – breasts that become uncomfortably full and hard when your milk ‘comes in’, usually around days two to four – is to feed your baby frequently. A breastfeeding specialist can show you how to massage your breasts and hand express or pump to relieve the pressure. If your baby cannot breastfeed because of the engorgement, you’ll need to see your midwife or a lactation consultant. Read more on engorgement.
Concerns about supply
Many mums worry about their milk supply over the first few days. A peer supporter or your midwife or nurse can reassure you it’s usual for your baby to feed every hour or two at this time. As long as he is producing plenty of wet and dirty nappies and gaining sufficient weight, all should be well. Read more about what to expect the first week of breastfeeding.
If your baby isn’t gaining weight, a breastfeeding counsellor or lactation consultant will be able to devise a feeding plan to ensure he is nourished and your supply is protected. Read more on low milk supply.
It’s good to talk
Sometimes you may just want to be reassured that your baby’s behaviour – such as feeding very frequently or waking often at night – is normal, especially if you’re a first-time mum. In this case it can be comforting to talk to someone who has breastfed their own baby and knows what to expect, such as a peer supporter or counsellor.
The important thing to remember is that, although it can be tiring at first, with the right preparation and support, breastfeeding can be plain sailing. And if problems do arise, getting expert help early can steer you back on course.