First,
it is important to understand that there is very little that you need to do to
prepare for breastfeeding. Your body has already done most of the
necessary preparation, and is producing colostrum (the first form of
breastmilk) by week 26 of your pregnancy.
Therefore,
this handout covers: optional supplies you may choose to obtain before baby is
born, things you should not do to prepare for breastfeeding, and some
things you may want to do.
Nursing
Bras
While
breastfeeding, women’s breasts tend to be heavier and fuller than usual, and
most women find they are more comfortable if they wear a supportive bra.
If
you normally wear soft cup bras, you may find it works fine to use these:
simply pull the cup down below your breast, exposing the nipple for nursing, but
leaving breasts supported.
Or,
you may choose to buy special bras, which have flaps that open out from the
center, or down from the top to expose the nipple. Shop in the final weeks of
pregnancy: The band should fit on the tightest hook, and be able to loosen a
little if needed. If you can just slip a hand inside the cup; this will allow
for a little breast growth during nursing.
Nursing
Pads
Sometimes
nursing moms’ breasts leak milk. If your breasts leak, just use your hand or
forearm to put a little pressure on the breast till leaking stops. If you leak
often, you’ll want nursing pads: you tuck one in each side of your bra to
prevent milk from leaking through your shirt. It’s important to change pads
anytime they get wet: wearing wet pads can cause sore nipples.
Some
women use plastic breast shells to catch leaking milk, but this may cause more
leaking.
Breastfeeding
Clothing
You
can breastfeed discreetly in almost any shirt you already own (t-shirts,
sweaters, sweatshirts, etc.): when you are holding baby in your arms, simply
lift the shirt up from the waist, up over the lower part of your breast, then
slip your bra down to expose the nipple and latch baby on. Baby will cover any
skin you have just exposed.
If
you prefer, there are special nursing clothes available with a variety of
openings. These can be useful for moms who are learning to breastfeed, or moms
who are especially worried about nursing in public. You can get nursing
wear at maternity stores, online, or at consignment shops.
Checking
for Inverted Nipples
You
may hear about “inverted nipples.” When pressure is applied to the areola,
these nipples sink down into breast tissue rather than protruding outward, or
becoming flat. Also, they do not become erect when cold or stimulated. About
1/3 of women have inverted nipples at some point in pregnancy, but only 10%
remain inverted by the 9th month.
To
test for this, hold your breast with your thumb and index finger at the edge of
the areola, and gently press thumb and forefinger together. If the nipple sinks
in, or seems to disappear into the breast tissue, it is considered inverted.
Babies may have a more difficult time latching on in the first few days,
but typically, baby’s suckling helps the nipple to protrude over time.
There
are two possible treatments for inverted nipples. One is to wear plastic breast
shells in the final weeks of pregnancy, which gently draw the nipple out. The
other is “Hoffman exercises”: which gently stretch the nipple tissue.
Interestingly, a clinical trial showed no significant benefit to these
treatments, and found that “no treatment” appeared to be the best option.
For
more info, see www.breastfeedingbasics.com/html/flat_inverted.htm
or www.breastfeed-essentials.com/invertednipples.html
Some
sources recommend use of “nipple shields”, soft plastic shields worn while
nursing baby, to help draw a nipple out, and to protect sore nipples. Be
aware that nipple shields can interfere with milk production, and should not
be used without the advice of a lactation professional.
If
you have any other specific concerns about your nipples, your breast shape,
previous breast surgeries, health, or any other issues which may affect
breastfeeding, you can ask your caregiver for a referral to a lactation
consultant for a consultation before baby is born.
Toughening
Up Your Nipples??
You
may also hear a variety of advice about how to “toughen up” your nipples prior
to birth. Here’s what not to do:
· Do NOT rub your nipples
with a nail brush (or even a washcloth) to toughen them. This may irritate nipples,
and may cause uterine contractions.
· Do NOT apply alcohol, witch
hazel, tincture of benzoin, or Vaseline to harden / prepare the nipples. This
may irritate the nipples and predispose them to pain and cracking.
· Do not use soap on your nipples.
The glands on the nipples secrete a substance which helps keep them clean and
moist, and soap can dry them out.
These
things are not harmful, they may
help toughen nipples,
but they’re
not necessary:
· For a few minutes every
day, or longer if desired, expose your nipples to fresh air.
· You can go bra-less
occasionally, or wear a nursing bra with the flaps down, which lets the nipples
rub against your clothing. May prepare nipples for handling friction.
· Lovemaking with gentle oral
or manual stimulation of the nipples.*
· You may hear that
expressing colostrum or massaging breasts prior to birth helps avoid
engorgement. These methods don’t appear to affect engorgement, but they’re
generally not harmful.*
*A
general caution: Nipple stimulation in pregnancy can cause uterine contractions
and could induce labor. Minimal stimulation is not likely to cause any
problems, but if any of your actions are causing contractions, you should stop
and consult caregiver.
Some
women attempt to induce labor, or increase the strength of contractions, by
using nipple stimulation. This should only be done under the advice of a
caregiver.
Supportive
Caregivers
Before
baby is born, surround yourself with people who know about breastfeeding,
support breastfeeding, and believe that it will work for you and your baby.
Especially important: make that your partner, other family members, your baby’s
doctor, and any babysitters or childcare providers you work with are educated
about breastfeeding, and prepared to support you with it.
c.
Janelle Durham, 2004.
If you have
had breastfeeding reduction surgery, I am told there is lots of helpful
information on Diane
West's website www.bfar.org, the forums
there, and her book Defining Your Own Success.