Most women make their decision to breastfeed either prior to pregnancy or during the first trimester. Early consultation with a relevant healthcare professional is therefore important to help the mom to reach her breastfeeding goals. The opinions and practices of obstetric and paediatric healthcare professionals have been consistently associated with maternal breastfeeding outcomes. The mom should be encouraged to discuss her breastfeeding goals with a healthcare professional and decide on a breastfeeding plan along with a labour plan prior to giving birth.
Medical history and breast examination
During prenatal meetings with an obstetrician or relevant healthcare provider, a woman's medical history should be taken in the context of future breastfeeding. It should be complete and cover previous conditions, medications, diet and other relevant issues. Any conditions, medications or previous breast surgery that may interfere with breastfeeding should be discussed. In addition, previous breastfeeding history and potential barriers to breastfeeding should be discussed. Physical examination of the breasts and nipples, and symmetry of the breasts can be performed at the early prenatal visit to ensure that the mom is aware of any potential breastfeeding issues that could arise.
Both the medical history and the examination of the breasts can be used to educate the woman about her breasts, any anatomic issues that may impact breastfeeding and any dietary or drug-related issues that may be of concern. In addition, this discussion can be used to reassure the mom about breastfeeding and encourage evidence-based breastfeeding strategies after birth. These include encouraging early and frequent breastfeeding, avoiding supplementation and any issues that may arise in hospital.
Further topics can also be discussed, such as breastfeeding practices once the mom has returned home from hospital, practical breastfeeding and breast milk storage tips, returning to work, and choosing a breast pump. Educating close family members is also important. Studies have consistently shown that women with family members and healthcare providers who are supportive of breastfeeding are more likely to breastfeed and reach their breastfeeding goals.
American Academy of Pediatrics and The American College of Obstetricians and Gynecologists. Breastfeeding handbook for physicians 2006).
Lawrence, R.A. & Lawrence, R.M. Breastfeeding: a guide for the medical profession (Elsevier Mosby, Maryland Heights, MO, 2011).
Odom, E. C., Li, R., Scanlon, K. S., Perrine, C. G. & Grummer-Strawn, L. (2014). Association of Family and Health Care Provider Opinion on Infant Feeding with Mother’s Breastfeeding Decision. Journal of the Academy of Nutrition and Dietetics, 114(8), 1203–1207.
Ramakrishnan, R., Oberg, C. N. & Kirby, R. S. (2014). The association between maternal perception of obstetric and pediatric care providers’ attitudes and exclusive breastfeeding outcomes. Journal of Human Lactation, 30(1), 80-87.
Perrine, C. G., Scanlon, K. S., Li, R., Odom, E. & Grummer-Strawn, L. M. (2012). Baby-friendly hospital practices and meeting exclusive breastfeeding intention. Pediatrics, 130(1), 54-60.