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How can parents-to-be prepare themselves for breastfeeding (chestfeeding) ? 

While still pregnant, parents-to-be can go to La Leche League Meetings and other breastfeeding support groups where they can see real parents feeding real babies! They will learn what obstacles they may face and the strategies to manage breastfeeding and a new baby. I also recommend making a birth plan – birth has a direct impact on how breastfeeding gets started. Interview postpartum doulas and think about having one on your team. Inform all the close people in your social circle that you will be breastfeeding – as opposed to saying you are going to try to breastfeed. – Leigh Anne

It really helps to understand the rhythms of newborn feeding by reading a good book (like The Womanly Art of Breastfeeding from La Leche League), a good article (like this one), or by attending a prenatal class; visit a La Leche League meeting prenatally so you can see other parents nursing and make a connection with your local La Leche League leader; bookmark Kelly Mom (which has reliably evidence-based information about lactation); learn about “natural” or “laid back” breastfeeding positions, which can save your arms, neck and shoulders; line up support from a postpartum doula; assemble your team of helpers (as opposed to just visitors!); and gather contact info for lactation support pros in your area and lactation support groups. – Meema

The best way to prepare yourselves as parents-to-be is by watching others. Humans learn best from watching other human behavior, and seeing it happen organically around them. Unfortunately our current society isn’t as open as it should be for this to happen generation after generation.  My advice is to learn as much as you can by reading books, doing a breastfeeding prep class but the most helpful thing would be to attend a support group where you can see other moms breastfeeding their babies. Listen to the questions they bring up and observe them getting help when latching the baby. Coming to a support group will not only allow you to see and learn from others but it will also give you a chance to ask your own questions with a Lactation Consultant.  As a lactation consultant, I love when I can meet Moms while still pregnant to be able to give them the information they need to be successful and get off to the best start possible. – Elina

What are the most common challenges when it comes breastfeeding (chestfeeding)

The most common challenges I see are: shock of caring for a new little person 24/7, the “unknown”, and misconceptions about what babies are like. I find that there is a lack of education from the community and support systems about how breastfeeding works, and a popular marketing of products and services that actually interfere with breastfeeding. – Leigh Anne

The most common challenges that I see my clients face are dealing with conflicting information and spotty support in the hospital postpartum; a painful latch (how your baby attaches to the breast); and anxiety around making enough milk (which is often a lack of understanding about normal newborn feeding patterns). And what I often hear after the fact is that many parents simply didn’t have the support they needed in those early days and weeks. The good news is that most problems can be overcome with help from a lactation professional or by reaching out to a La Leche League leader! – Meema

Learning to nurse your baby amidst all the changes that happen so abruptly is a huge challenge I see. And then overcoming the feelings of anxiety and not knowing what to do in the event that feeding the baby is difficult is probably the hardest and scariest.  Getting help as early as you can will get you on a path to ironing out all the issues and establishing a plan for what to do so as not to disrupt your ability to achieve your breastfeeding goals. – Elina

How can partners best support the nursing parent? 

My advice for the partner: Be the gatekeeper – the non-birthing partner can screen calls and visitors, take the lead in the other household needs, offer to hold/wear baby while the birthing parent rests or has some personal time, like a shower or bath. Also, make sure the birthing parent is fed and has their needs met physically and emotionally. – Leigh Anne

My top piece of advice is to learn alongside your partner by reading the same books, articles or attending a class together. On a more practical note, be ready with a glass of water and snacks that are easy to eat with one hand. (Nursing can make a person really hungry and thirsty!) Become a pro at burping, diaper changing, infant soothing techniques and babywearing so that you can fully participate in the early days and weeks before you start bottle feeding. And finally, know that when someone faces difficulties with nursing, it can be very emotionally challenging, so be ready to listen, validate and support. – Meema

Deciding to nurse does require a huge commitment on the part of the mom. The partners are best when they can 1. Be a cheerleader and give lots of encouragement to her especially if she is having trouble. Research shows this is one of the biggest determinants of whether a mom will persevere and continue breastfeeding. 2. Take as many other responsibilities off her plate as possible or seek out family/friends/hired help to do so while she nests in and focuses her energy and attention to the baby and her healing. 3. Help out with the other aspects of baby care including burping, diapering, and getting baby to sleep so that mom can get a nap in, rest, eat, or shower and 4. Limit the amount of visitors in the first few weeks so that mom and baby can get to a place where things are smoother and more manageable. – Elina

When/how can parents begin pumping and bottle feeding? 

This depends on the needs of the family – if the baby is nursing well and there is no need for separation there is no need to pump. If the baby is separated from the birthing parent or not latching or not gaining weight then the birthing parent will want to start pumping right away – ideally with a hospital grade pump, if the breastfeeding parent is returning to work or needs to be away then they can start pumping a few weeks before the separation is expected. Typically it is a good idea for the first pumping session to be in the morning after the first nursing session when they are up for the day. They may not get much but this is a good time, once a day like this for a few days until there is enough to fill a 2-4 ounce bottle(depending on baby’s age). Then when the baby takes a bottle, the parent can pump. –  Leigh Anne

If possible, wait until three weeks after your baby’s birth. I understand that other family members are eager to participate in feeding a new baby, but generally speaking, bottle feeding won’t improve a baby’s latch, so it’s better to wait until you’ve gotten into a groove with nursing and baby is gaining well. I also let my clients know not to pump to check and see how much milk they’re producing— it’s not an accurate measure! Once you do start pumping and bottle feeding, I highly recommend using a “hands on” pumping technique which yields more milk and practicing paced bottle feeding with a slow flow (or newborn) nipple, so baby can more easily go between breast and bottle. – Meema

The best time to introduce pumping is after the baby has been exclusively breastfeeding (with no difficulty) for 3 weeks.  This means that the baby is able to latch deeply, drain a breast, take both sides, have good urine output and weight gain. Once the baby is able to do all of this, it’s ok to introduce a bottle slowly, every other day or so. Once you are ready to do this you have 2 choices: 1. You can wake up and pump in advance of when the baby is likely to feed, and then bottle feed what you pumped once it’s time for the next feeding or 2. Two weeks in, pump a little out after a morning feed or two and only take out a little each day so that you have a stash when ready to introduce a bottle. A consultant can give you more details with regard to how to do this safely.  If there is a question about milk supply and whether the Mom needs to do some pumping in order to increase the stimulation and therefore supply, then you will need to start pumping much earlier, but that would be determined by a lactation consultant after being evaluated so an individualized plan can be made. – Elina

What is an amazing little known fact about breastfeeding?

There is an element in breastmilk that causes cancer cells to implode. It is called HAMLET! (human alpha-lactalbumin made lethal to tumor cells). – Leigh Anne

I first discovered this impressive fact from Angela Garbes, who wrote the article, The More I Learn About Breast Milk, the More Amazed I Am as well as the excellent book Like a Mother: Breast milk changes daily based on signals from the baby. (My emphasis added, because, wow!) Garbes goes on to explain, “[W]hen a baby suckles at its mother’s breast, a vacuum is created. Within that vacuum, the infant’s saliva is sucked back into the mother’s nipple, where receptors in her mammary gland read its signals. This ‘baby spit backwash’… contains information about the baby’s immune status. Everything scientists know about physiology indicates that baby spit backwash is one of the ways that breast milk adjusts its immunological composition. If the mammary gland receptors detect the presence of pathogens, they compel the mother’s body to produce antibodies to fight it, and those antibodies travel through breast milk back into the baby’s body, where they target the infection.” So, yes, like Angela Garbes, the more I learn about breast milk, the more amazed I am!! – Meema

I love this question! The science geek in me is fascinated by all the things they keep discovering about human milk, it’s different properties and what it does.  An article from a few years back describes how the saliva from when the baby nurses (the backwash) gets into the breast and lets the immune factors know what kind of antigens are in the baby’s world! The mom’s body then makes “made to order” antibodies for the baby to ingest when nursing to protect them better. Also, the more a mom can nurse in environments in which the baby attends often (daycare, classes etc) the more specific antibodies can be made to further protect the baby! – Elina

About Elina 

Elina Aluraj’s first profession was as a Physical Therapist. However after 10 years of practicing in all disciplines including Women’s Health for many of those years, she came to realize and find her true passion, Lactation Consulting. It was through her sister’s struggles trying to nurse premature babies that she initially realized her love for this profession and she wanted to get certified to help as many new and seasoned Moms as she could.

It wasn’t until she had her own that she came to understand the real commitment it takes, the struggles you have and the desire to do your absolute best for these new little lives you are responsible for.

She has been a International Board Certified Lactation Consultant since 2009 and working to empower Moms and helping babies breastfeed since 2007. Together with her husband, she is the proud Momma of exclusively breastfed twin boys and a girl.

About Leigh Anne 

Leigh Anne O’Connor is an International Board Certified Lactation Consultant with over two decades experience working with breastfeeding families. Leigh Anne is a past President of New York Lactation Consultant Association (NYLCA), a member of International Lactation Consultant Association (ILCA), and a past member of the Bank Street Head Start Health Advisory Board.

Leigh Anne teaches breastfeeding classes, leads support groups, teaches Master Classes and sees private clients all over New York City. She is also a mentor for aspiring Lactation Consultants.

Leigh Anne has appeared on television, radio and in documentaries as an expert and advocate for breastfeeding, promoting its health and societal importance. She has appeared on The Nancy Grace Show, Fox 5 News, The Doctors, TLC’s Bringing Home Baby, Montel and Runway Moms and is seen regularly on the Newborn Channel. Other appearances include: Good Morning America, the Montel Williams Show, WCBS News and WOR radio. Leigh Anne blogs at www.mamamilkandme.com and is the proud mother of three breastfed children. 

About Meema

Photo Credit: Lucky Gordon

Meema Spadola is a DONA (Doulas of North America) trained and certified postpartum doula (since 2006), a Certified Lactation Counselor (since 2010) and is also certified in infant CPR.  The New York Times described her as “a modern Mary Poppins: a combination friend, teacher and spirit guide…” A former documentary filmmaker, Meema enjoys working with a diverse range of families, including single, adoptive, and LGBTQ+ parents. She is the proud mother of a son born in July 2007 and lives with her family in Kensington/Windsor Terrace, Brooklyn. Read more at www.meemadoula.com.