Prepare for Breastfeeding and Avoid Common Complications by Dr Robyn Thompson
Whether she is giving birth to her first baby or her fifth, every woman deserves the right to experience the beauty and joy of nourishing her baby with her own body – stress and complication free – for as long as she chooses.
Yet, in the run-up to labor and amidst the myriad concerns surrounding childbirth itself, breastfeeding often takes a backseat. Many pregnant mothers may think, “I’ll focus on my labor and birth first and worry about breastfeeding when I get there – breastfeeding is natural, so how hard can it be, right?” Well, not quite right. Breastfeeding may be natural, and while some women may take to it from day one, for many, it isn’t quite the walk in the park they had hoped for.
If you’re pregnant and that sounds like you, as a midwife for over 50 years, I would like to share two things:
Natural doesn’t always mean easy.
It is possible to enjoy a positive breastfeeding journey – but successful breastfeeding starts with preparation.
Pregnancy is a time of transition in your body and the best way to use it is as an opportunity to prepare for what’s to come. The choices you make now will lay the groundwork for your labor, the birth of your baby and your breastfeeding journey.
How hospital births usually go (and the impact on breastfeeding)
In my experience, many women wait until their little one is already in their arms to start thinking about breastfeeding. They rely on hospital staff to guide them, as they feel that they’re in expert hands. However, hospital systems and policies are often based around time efficiency, and not necessarily helping mothers get breastfeeding off to a good start.
As a result, approaching labor and breastfeeding without being prepared usually looks something like this:
Due to time constraints, a mother is subjected to the hospital’s agenda to rapidly process her in, through, and out of the hospital to early discharge.
Accelerated labor may involve unnecessary induction of labor that triggers further medical interventions, known as the ‘cascade of intervention’. This ranges from sweeping of membranes or the administration of synthetic oxytocin, which increases the need for opioid pain relief that could negatively impact how a mother and her baby proceed through the rest of her labor, to an emergency C-section in more extreme cases. (A cesarean section may be a blessing in circumstances when it is necessary, but considering that it is major abdominal surgery, it’s preferable to be avoided if at all possible.)
Once the newborn baby has arrived, the first breastfeed is often delayed or interrupted as the baby is handled by hospital staff for non-urgent routine procedures – all of which can wait if the baby is healthy and has an Apgar score of 7 or above.
Turning to hospital staff for help, once mother and baby are reunited, the baby is often held by the back of the head and forced to her breast in a way that significantly increases the risk of nipple pain and discomfort.
Breastfeeding techniques commonly taught in the hospital system are often outdated and unhelpful, particularly the ‘cross-cradle technique’.
If a mother asks for help, she is likely to be met with inconsistent and conflicting advice from hospital staff and well-meaning family and friends, leaving her more confused, overwhelmed, and disheartened.
The worst part? This is exactly the sequence of events that leads to painful but all-too-common breastfeeding complications such as painful nipple trauma, breast engorgement, and mastitis. All of this is supported by the evidence in my PhD research, which reveals that painful nipple trauma is closely associated with the forceful breastfeeding techniques that are taught in most hospitals.
Unsurprisingly, this miserable reality ends up being far too much to bear, and many women feel they have no choice but to stop, often sooner than they’d hoped and planned. On top of their physical pain, this can leave them feeling defeated and disappointed, because they didn’t meet their breastfeeding goals, and because they wound up making a decision where they felt that there was no alternative, making them feel powerless.
The power of preparation
Everything I have described here is a lot more likely to happen when a mother is not prepared and doesn’t know what to expect from her labor and breastfeeding experience. But the good news is that all of this can be avoided. After all, prevention is better than the cure, and this is especially true for breastfeeding, where it is much easier to prevent complications than it is to cure them. What’s more, postpartum you’ll have enough to cope with as you adjust to life with a newborn.
This is why I firmly believe that knowledge is power and the best thing you can do while you’re pregnant is to learn all you can – about what happens to your body during labor, who will be with you as you give birth, what to expect if medical intervention is recommended, and, very importantly, what your rights are. It’s vital to understand your rights within the hospital setting, and to say ‘no’ or ‘please wait’ if anyone oversteps your boundaries in the interests of efficiency and at the expense of your or your baby’s wellbeing.
Crucially, this applies to the time window right after you give birth to your baby, which is the best time for your baby to start breastfeeding. I cannot overstate the importance of protecting these first precious moments, which is why I refer to them as the 3 Golden Hours.
Remember: in the absence of an emergency or urgent situation, your top priority is the very first breastfeed – everything else can and should wait. It isn’t fair that you should have to struggle with breastfeeding just because of the mad rush, driven by the hospital system. You do have a say in how it all unfolds, so please don’t let strict time constraints place you under pressure to make quick decisions that don’t align with your plan.
In fact, crafting a well thought out birth and breastfeeding plan will provide you with the clarity to make informed decisions that could profoundly influence your labor and how you and your baby fare with breastfeeding. And having a strong advocate by your side during your labor and birth, who understands and supports your preferences, can help make sure that you receive the respect from the hospital that you deserve.
My final thoughts
While the idea of preparing for breastfeeding may seem like a lot of work, especially when you already have your labor and birth to deal with, preparation really is half the battle. And when breastfeeding goes well, it is 100% worth it. No mother should have to struggle through unbearable pain to breastfeed her baby. Every mother should be able to breastfeed her baby, pain-free if she wants to, and for however long she chooses.
Investing the time in breastfeeding preparation while you’re pregnant could save you hundreds (even thousands) of dollars in lactation consultants, formula, and breast pumps. And it means that you get to focus exclusively on nurturing your maternal instincts, your baby’s instincts for feeding, and on falling into a natural breastfeeding rhythm that nourishes both your baby and your lifelong bond with each other.
Bringing a new life into the world is, without a doubt, a momentous event that marks the start of many new beginnings. The start of a brand-new life, of a strong connection between mother and baby, and also the start of a mother’s breastfeeding journey.
Breastfeeding is meant to be a beautiful experience that offers incredible health benefits for your baby, so I truly hope that you have the wonderful pregnancy, smooth labor, gentle birth, and pain-free breastfeeding journey that you deserve.
Happy birthing and happy breastfeeding!
Dr Robyn Thompson is a midwife with over 50 years of experience who was awarded a PhD for her extensive research into breastfeeding and nipple trauma. Dedicating her life to the cause, Dr Robyn founded The Thompson Method – an evidence-based approach to gentle birth and breastfeeding that helps thousands of mothers nourish and connect with their babies through pain-free breastfeeding. For more information on Dr Robyn and The Thompson Method, visit https://www.thethompsonmethod.com/and follow her on Instagram @the.thompson.method and on Facebook: https://www.facebook.com/DrRobynThompson/.
You can sign up for her online breastfeeding program on https://www.thethompsonmethod.com/breastfeeding-course and join The Thompson Method Facebook group: https://www.facebook.com/groups/thethompsonmethodbreastfeedingclub/.