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Feeling "Totally Clueless" - How to prepare?
By Anne Smith, IBCLC

Anne Smith, IBCLCQ. I am currently eight weeks pregnant with my second child. I did not breastfeed my first, who is 9. I want to breastfeed this one but I am totally clueless. Do I need to do anything to prepare my breasts? Should I use a breast pump or hand express the milk? Which is better the electric pump or the manual pump? I know I have a long way to go yet but I am a planner and I like to make informed decisions. Any help you could offer me would be greatly appreciated.

A. Congratulations on your decision to breastfeed your new baby! You'll be so glad that you did. Breastfeeding is the most natural process in the world, but it isn't instinctive. You have to learn the mechanics of positioning, and educate yourself about the differences between breastfeeding and formula feeding so that you know what to expect. It's difficult not to make comparisons when you have already had a baby, but comparing breast and bottle fed babies is like comparing apples and oranges.

There is no one best way to prepare for breastfeeding. You can't toughen up your nipples in advance, and you can't predict what breastfeeding problems (if any) that you will encounter. You need to educate yourself as much as you possibly can in advance. Take classes if they are available, read books (I recommend Dr. Sears' book called The Breastfeeding Book and La Leche League's The Womanly Art of Breastfeeding), talk to other nursing mothers, attend La Leche League meetings if there is a group in your area, and find a "breastfeeding friendly" doctor.

Finding out what kind of support is available after your baby is born is just as important as educating yourself in advance about the basics of breastfeeding. Because there is no way to predict exactly how things will go once the baby arrives, it is helpful to know who to turn to for help when you have questions (and you will have questions, no matter how much advance preparation you do). Find out if the hospital where you are going to deliver has lactation consultants on staff, and request a consultation as soon as possible after the baby's birth. Some hospitals have enough LCs on staff to visit every nursing mother, while others only provide LC services if the doctor places an order for them. Most major hospitals have IBCLCs on staff, and some are in private practice in the community. Some hospitals have lactation centers that offer outpatient services after you leave the hospital, and most LCs in private practice also work with mothers individually after hospital discharge. Check around to find out what services are available and prices in your area.

Even if you have excellent help while you are in the hospital, you will find that most of your questions will be about things that happen after you go home. If you have an uncomplicated vaginal birth, then you will probably be at home by the time your baby is 48 hours old. Common problems like engorgement, nipple soreness, and jaundice usually don't occur until after the baby is 2-3 days old, so having someone to turn to for advice after you leave the hospital is very important.

As far as choosing a breast pump goes, it really depends on your individual situation. If you have medical complications such as prematurity or low weight gain, then you might need to rent a hospital grade pump like Medela's Classic for a short time. If you are staying at home with your baby and you take him with you everywhere you go, then you might not need a pump at all. If you want to pump occasional bottles for outings, then you might want to purchase a manual pump or a small electric/battery pump like the MiniElectric. If you are going to be working and pumping several times a day on a regular basis, then you will probably want to rent or buy a hospital or professional grade pump like the Lactina or the Pump In Style. You can find information about the pros and cons of different types of pumps on my website and in the article "Collecting and Storing Breastmilk."

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Start attending La Leche League meetings during your pregnancy. You'll get to meet lots of happy nursing couples, as well as have access to tons of excellent information about pregnancy, parenting, and breastfeeding. La Leche League is a great source of support for all expectant and nursing mothers.

You can find an IBCLC in your area by contacting ILCA (International Lactation Consultant Association) at 312-541-1710 or by e-mail at ilca@erols.com.

You can find out how to locate your nearest La Leche League group by calling 1-800-LALECHE or going to their website: laleche.org.

Remember that nearly all mothers can breastfeed successfully if they are strongly committed and know where to get the information and support that they need. The first couple of weeks are challenging, but ask any mother who has hung in there and she will tell you that nursing your baby is worth doing whatever it takes to make it work for you.

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