Breastfeeding: Strategies for Success 

The Advantages
The American Academy of Pediatrics recommends breastfeeding for at least the first year of baby's life. Breastfed children have fewer ear infections, lower respiratory infections and urinary tract infections than formula-fed children.  They also have diarrhea less often. 

Yet you may think that breastfeeding is old-fashioned and wonder how you can manage breastfeeding with the challenging life you lead. Here are ways to apply strategies that you already use in your life to make breastfeeding work for you and your new baby.

Check Out Your Options
One thing to consider when choosing where to deliver your baby is the facility's commitment to breastfeeding. Breastfeeding success begins at birth: the baby is awake and ready to learn to suck in the first hour or so after birth.

Your choices during labor also affect how easy it is to get started. If you take pain medicine during labor, you might need to be more patient and persistent in working with your baby as he or she learns to feed.

If you choose a doctor for your baby before birth, be sure he or she supports breastfeeding. You should ask what the doctor would recommend if you were to have difficulty breastfeeding. A supportive doctor would refer you to a lactation consultant rather than recommending that you switch to formula.

Get a Mentor
Find someone—such as a friend, sister or colleague—who has enjoyed breastfeeding, and ask for advice and information. Plug into their network and fill your phone book with numbers of La Leche League leaders, lactation consultants and experienced breastfeeding mothers.

Reach out for help right away if breastfeeding is painful or frustrating, especially in the early days and weeks after baby is born. International Board Certified Lactation Consultants (IBCLCs) are allied health professionals who are experts in breastfeeding management. You can find a board-certified lactation consultant "through the grapevine," through the International Lactation Consultant Association at (919) 861-5577, or through your hospital or birthing center. Lactation consultants assess mom and baby, watch baby feed, and offer a care plan to improve breastfeeding comfort and effectiveness.

Expectant mothers are welcome at La Leche League (1-800-LA LECHE) meetings. Many lactation consultants run support groups for breastfeeding mothers, as do some hospitals and almost all birthing centers. These groups are great places to watch how other mothers hold their babies to breastfeed and get advice.

Gather Your Resources
Plan for the right kind of help after baby is born. Surround yourself with people who support your decision to breastfeed and who will help your family while you and your baby learn to breastfeed together.

You may consider hiring a doula. A postpartum doula is trained to provide support to new moms and families. She can give you baby care and breastfeeding tips, and can do housework, shopping, laundry, and prepare meals—anything to give you time to recover from birth and get to know your new baby. Most doulas are knowledgeable about resources such as lactation consultants and support groups.

If paid help is not in the budget, perhaps a friend or relative could come help out for a few days. Remember to be very clear about your needs and expectations, especially if the helper is a family member.

Go Shopping
Mothers who are returning to work or school usually need a breast pump. Since you won't know in advance how often you'll need to pump, it's usually best to purchase a pump after the baby is born.

There are a variety of pumps available; one is sure to meet your specific needs. Manual pumps are often preferred by women who pump infrequently, while working women often prefer electric double pumps.

A lactation consultant can help you evaluate your needs and choose wisely. Do window shop, and have all the information you need about several types of pumps handy so you can send someone else to pick up the pump if you need it soon after birth. You will also need bags or bottles to store pumped breastmilk (also called "expressed breastmilk").

Some good books about breastfeeding round out your supply kit. Most La Leche League groups maintain a lending library of good books. Public libraries and bookstores also have many choices. Be sure the books you choose are recent, and not published by companies that might profit from early weaning.

Dress for Success
Several companies sell breastfeeding clothes with flaps or hidden slits to make breastfeeding discreet. These are convenient, but any two-piece outfit with a shirt that pulls up (rather than unbuttons) can work well. Once baby is latched on to your breast, you can settle the shirt hem so that little or no breast shows. Practice in front of a mirror until you feel confident. If you are particularly shy, a vest or sweater will provide additional coverage from the side.

Learn About Medications and Breastfeeding
For information, visit the Web site Medication Use During Pregnancy and Breastfeeding.

Get Help from Your Partner
Breastfeeding: What Dad Can Do provides information about how your partner can help out.

Breastfeed at Work
If you are planning to return to work, you have a lot more to think about. Before you begin your maternity leave, find out if there is a lactation policy or benefit in place. Ask if your employer will give you a private place and time to express milk. Can you work from home a few days a week or ease back into work part-time? Helping you to continue breastfeeding your baby is in an employer's best interest, as mothers of breastfed babies miss work less often because their babies are sick less often.

You will probably need to pump two to three times in a full-time workday, for about 10 to 15 minutes each time. Most working women find an electric double breast pump easy to use and most efficient. Your child care provider should support your breastfeeding relationship with your baby by feeding your child expressed breastmilk&m