Breastfeeding: Starting out Right

Breastfeeding:  Starting Out Right

Expecting Moms often ask me, “How can I start out right breastfeeding my baby?'

My quick answer is:

* Skin to skin:  As soon as the baby is born he/she should be placed on mom’s chest, skin to skin, and have access to the breast. This is the beginning of a good breastfeeding experience and should be kept up as much as possible in the first few weeks of life.

** Early feeding: Newborns usually have an alert time the 1st hour after their birth and it is the perfect time for them to breastfeed!  Going from skin to skin to latching-on for a 1st feeding is a great predictor of breastfeeding success. A proper, non-painful latch is critical.

*Frequent, nonrestricted breastfeeding:  Newborns will often feed frequently the first few days after birth. This is normal newborn behavior and helps establish the milk supply. A good latch, breast compressions, and maintaining skin to skin contact helps this transitional period go well. 

*Avoid all supplements and artificial nipples, unless medically indicated, and breastfeeding is well establish.

Here are some other things to consider:

Before your baby is born, gather as much information possible and educate all family members about your infant feeding choices. Talking to friends and family and your midwife or doctor, as well as attending a Breastfeeding education session or class will give you the opportunity to ask questions and address any concerns you may have.

Here are some of the “Basics of Breastfeeding” that are important to cover in any Breastfeeding education session:

• How breastfeeding works.

• How to establish a good milk supply/skin to skin/early breastfeeding expectations.

• Positioning & Attachment (how to hold and attach your baby to the breast).

• How to know your baby is getting enough milk.

• Discussion of what is “normal” for a breastfeeding infant.

• Learning your babies hunger cues.

• Roles of partners in breastfeeding.

• Adjusting to parenthood - Survival tips for the early days & weeks with a new baby.

• Overcoming common obstacles & problems that may occur.

• When & Where to get help when you need it. The most important information you need!!!

Line up your “Support Network” before the baby is born:

Finding a Breastfeeding Support Group is a huge help to get support before and after your baby is born.  We are lucky to have an excellent “Postpartum Resource Guide” to help new parents find the appropriate support in the Bozeman community.

Choosing a healthcare provider for your new baby before your baby is born is an important decision to make.  The provider and office staff need to be there to support your family infant feeding choices.  Many pediatrician offices now employ Lactation Consultants (IBCLC’s) or Lactation Counselors (CLC’s) to support breastfeeding families. This is a great clue the office values Breastfeeding.

Many new parents like to go online to search for information, but this can also create more confusion, misinformation and therefore increased anxiety.  I recommend kellymom.com,leleacheleague.com, or JackNewman.com as quality online sources of information.

I hope this is helpful getting you and your baby off to a great start breastfeeding. Good luck!

Scope of Practice

Let's talk about credentials and scope of practice: how healthcare providers in the valley are here to help mothers in need.

To start this conversation we need to decipher just what the different credentials your health care provider may have when helping you with breastfeeding. There are several breastfeeding specific credentials that all have very different scope of practice and education background. Let's start with the Certified Lactation Educator (CLE). This is a person who has been trained to help educate families on the importance of breastfeeding and the basics of starting out right through classes, counseling and support. According to CAPPA who owns the trademark CLE and offers the courses , they “provide candidates with complete evidenced- based training for offering private and public breastfeeding classes, advocacy, and support.” They are not a clinician and refer out when support requires clinical assessment. A breastfeeding counselor is a wonderful addition to a team of healthcare providers working with families.

Next let's talk about a Certified Lactation Counselor (CLC). A CLC has taken a week long breastfeeding education coarse and sat an exam at the end of the week on the information covered. A Lactation Counselor is a very qualified person for the assessment of initial breastfeeding establishment, breastfeeding education and basic breastfeeding challenges. Breastfeeding Counselors are a critical part of the team of healthcare providers in rural areas where access to other professionals is limited or unavailable. Breastfeeding counselors are invaluable to WIC as support for breastfeeding mothers and a great asset to a healthcare team.

Finally let’s talk about an International Board Certified Lactation Consultant (IBCLC). For starters an IBCLC must have a four year degree, must have completed one of three pathways to become eligible to sit the boards, all of which include classwork as well as clinical work. For example: Pathway 2 is a yearlong course offered by 6 different universities with clinic rotations required. Once the course has been completed and the clinics have been completed and verified then one is eligible to sit the boards. The boards are offered internationally twice a year. Once passed you are then awarded the credential of International Board Certified Lactation Consultant (Lactation Consultant, IBCLC). A Lactation Consultant has a strict scope of practice (you can view here) and codes of conduct which should be adhered to in order to serve our communities with the best of our ability. We work in a healthcare team setting providing feeding assessments, feeding plan of care and practice through evidence based information. A Lactation Consultant has the professional obligation to refer to an appropriate care provider when a feeding assessment needs further expertise. An IBCLC is an asset to a healthcare team in their ability to work with the majority of breastfeeding issues with collaboration between physicians, midwives, NP’S, RN’s, OT’s, OB’s and other healthcare providers. Lactation Consultants also work closely with lactation educators, lactation counselors and doulas by being available for referrals when mothers and infants have feeding issues that require feeding assessment and care plans. 

The message I wanted to portray here today is that providing support through education, counseling and clinical assessment is a team approach and every member is a valuable contributor to the health and success of the mother and babies breastfeeding journey. As a member of the team it is so important to remember when it is appropriate to call on other healthcare professionals to step in when the mother or baby needs further assessment or the problem is simply outside of one's expertise. As healthcare providers in the Gallatin Valley we are all here to help mothers and babies succeed in their breastfeeding journey regardless of who helps them. My hope is that every breastfeeding woman, and family will have access to comprehensive lactation care and the support of her healthcare providers.