women

What to do now, and after the baby arrives, to bolster breastfeeding success

When I gave birth to my twins a few years ago, I thought I knew a thing or two about breastfeeding. My older son had nursed for 14 months with nary a problem, and I'd been researching, writing and editing breastfeeding articles for this magazine for more than 10 years.

Turns out there were a few things I didn't know- little things like how to maneuver two tiny bodies onto the nursing pillow to tandem-nurse. Lucky for me, though, my friend Keri a mother of not one but two sets of twins-swooped in to help. She was there for me with soothing words of confidence, practical help and more than a few desperately needed healthy meals.

What to do now, and after the baby arrives, to bolster breastfeeding success

According to Nancy Mohrbacher, I.B.C.L.C., F.I.L.C.A., a lactation consultant near Chicago and a co-author of Breastfeeding Solutions: Quick Tips for the Most Common Nursing Challenges (New Harbinger Publications), it's help like this that can make all the difference in a woman's decision-and, ultimately, her ability-to breastfeed. "Moms helping moms-with support, with advice, with hands-on help-is one of the best ways for women to succeed," she says. Want more tried-and-true ways to guarantee success for yourself? Read on.

1.    Hang with new moms

"Attend a breastfeeding support group or baby-care class before you have the baby," Mohrbacher advises. The goal is to spend time with other women who are already breastfeeding so you can not only learn from them, but find that all-important source of support for when your baby arrives. Doing so also helps you to develop what Mohrbacher calls "breast- feeding self-efficacy," or the belief in your own ability to breastfeed. "Being around other women who are nursing helps you to develop confidence and commitment, which is a very powerful force in helping you to succeed," she explains. Bring your partner, mother, even your mother- in-law to these groups and classes, as you'll want them to support your decision to breastfeed. And, of course, keep up with the group once you're nursing your own baby.

2.    Talk to your baby doc

Spend time interviewing potential pediatricians while you're still pregnant-and make sure yours recognizes and supports the importance of breastfeeding. "If a health care provider isn't completely supportive of your decision to breastfeed, find someone who is," advises Suzanne Haynes, Ph.D., senior science adviser at the Office on Women's Health in the U.S. Department of Health and Human Services. Support from your pediatrician can have a huge effect on your commitment and success. According to a 2003 study, women who received encouragement from their health care clinicians were much less likely to discontinue breastfeeding within the first 12 weeks.

Spend time interviewing potential pediatricians while you're still pregnant-and make sure yours recognizes and supports the importance of breastfeeding

3.    Choose where you'll deliver

If you have any options in where you'll have your baby, aim for a facility with a low Cesarean section rate-preferably less than 20 percent, says midwife Ina May Gaskin, author of Ina May's Guide to Breastfeeding (Bantam). According to a 2010 Italian study, C-sections are associated with lower rates of breastfeeding in the delivery room as well as exclusive nursing in the immediate postpartum period. (It's important to start nursing as soon as possible after delivery to help establish a healthy milk supply.)

Even better, deliver at a "Baby-Friendly" hospital or birth center; these facilities have received hard-won distinction for their dedication to breastfeeding. Though only 154 facilities in the U.S. have been given this designation so far, 90 more are in the process of becoming accredited. (Visit babyfriendlyusa.org for more information.)

According to a 2010 Italian study, C-sections are associated with lower rates of breastfeeding in the delivery room as well as exclusive nursing in the immediate postpartum period

If you can't deliver at a Baby-Friendly hospital or birth center, Haynes advises asking potential hospitals for their Perinatal Care core measure set from the U.S. Centers for Disease Control and Prevention and the Joint Commission on Accreditation of Healthcare Organizations. According to Haynes, this report measures the number of mothers who were exclusively breastfeeding at the time of discharge from the hospital. "You want to look for a high percentage," she says.

4.    Insist on late cord clamping

Waiting a few minutes to cut the umbilical cord allows the baby to receive more iron-rich placental blood, Gaskin says. This extra boost can help your baby breastfeed more vigorously. "Ask your doctor to wait until the cord stops pulsing before the cord is cut," she advises.

Late umbilical cord clamping makes for a more robust baby

5.    Get semi-horizontal

Rather than nursing in the usual sitting-up position, Mohrbacher suggests adopting a semi-reclined position to ease strain, "Recline the hospital bed or place pillows behind your back so your body is completely supported and your shoulders are relaxed, then place the baby belly down, directly on your chest," she advises. Mohrbacher also notes there will be some trial and error until you find what's most comfortable for you, and that the position in which you like to watch TV often works best. (For a visual of how to nurse your baby this way, visit fitpregnancy.com/reclinedposition.)

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