We plan for the births of our babies for months ahead of time. Then, the baby is born, and the 4th trimester starts. Postpartum is a new, very foreign phase of life that most of us aren't prepared for. A lot of new parents feel lost right after baby is born as their worlds have changed drastically. I hear a lot of moms wishing they would have had some education or a plan in place for feeding the baby before the birth. This is why I love prenatal breastfeeding consults. You end up with a feeding plan A, B and C and, if you need, a plan D. You get basic education on breast/chest feeding, and you have someone familiar to reach out to with questions.
Here are some of the things that I like to cover in a prenatal consult:
Medical and Surgical History: Taking in a thorough medical and surgical history can uncover things that could potentially impact breastfeeding. Knowing about these and having a plan can help combat any unforeseen "bumps" in the road.
Baby Stomach Sizes: Did you know that babies only take in about 1 tsp per feeding on their first day of life? Their intake slowly increases as the volume of your breast milk increases and changes from colostrum to transitional milk. Babies are still only taking in about 1/2-1 ounce by day 3 of life and average 3-4 ounces per feeding through the first 6 months of life.
Hand Expression: I like to model and teach the technique of hand expression. Hand expression takes practice but is an amazing skill to learn for use throughout your feeding journey.
Colostrum Collection: With consent from your provider, I like to teach how to collect colostrum after 37 weeks gestation, save it and bring to your birth. Most times you won't need to have extra colostrum, but it's a great thing to have if you do need it.
Early Feeding Cues: Trying to get a hungry, crying baby to latch is hard! Getting to that baby when they start expressing early feeding cues is key. Catching baby in a quiet/alert state when they're bringing hands to mouth, initiating the rooting reflex or moving the tongue around the mouth lets you know that baby is ready to eat before they start crying--a later sign of hunger.
How Often To Feed: Knowing when and how often to feed baby helps baby get what they need, avoids having baby sleep through feedings, and gives your breasts the stimulation they need to help your milk volume start to increase. Aim at a minimum of 8 times in 24 hours, but feedings are more likely to be needed 10-12 times in a 24 hours period or when baby is cueing to feed.
Latching Techniques: Watching a demonstration and getting key tips to latching really help us not feel so "lost" in those first couple weeks breastfeeding. The difference in a good and bad latch can mean nipple damage that is painful and takes time to heal.
Milk Volume: Lactogenesis II is the term that's used for when your milk volume increases. We typically see this happen between days 2 and 5 postpartum. I like to talk about what this looks like, ways to facilitate this transition, and things that can impact and delay L II from happening within its typical timeframe.
Pumping: Fitting flange sizes and trouble shooting how to use the pump and when to start pumping if necessary are all covered in a prenatal consultation. Did you know that most women don't need to pump, especially in the early postpartum days?
Feeding Plan: One of my favorite parts of a prenatal consultation is giving parents a plan for postpartum feeding and ways to tweak that plan if necessary.
Things happen during delivery and the postpartum period that we cannot control or predict. Having some education and knowledge can help make those changes less scary. Meeting with an LC before baby arrives gives you those plans, the confidence of feeling like you are prepared and that familiar face to reach out to if things don't go the way you thought they would.
Prenatal consults can be done anytime throughout pregnancy in person or virtually and are typically covered through insurance under lactation. Reach out to your local LC today!
XO,
Kelsey RN, BSN, IBCLC