Breastfeeding is filled with ups and downs. While there’s no way to prevent all breastfeeding issues, preparation can help you to feel empowered to know what’s normal, what’s not, and how to move forward through your breastfeeding journey. 

Knowing what to expect can help you feel more confident and prepared. If you are giving birth in the hospital, it’s important to be aware of some of the unique circumstances you might encounter. Here’s a guide to help you navigate your hospital experience a little more successfully: 

 

When to Offer the Breast

Immediately after delivery – barring any complications – your baby will be placed on your chest, skin-to-skin. Some babies are sleepier than others, but I recommend offering the breast at some point during that first hour. Babies often use their instincts to breastfeed at this time and can often latch with some assistance. 

I would also suggest hand expressing for a few minutes after you attempt to nurse during the first 24 hours. According to First Droplets, research shows that women who hand express after nursing during the hour after attempting to nurse have an increase in supply at six weeks. 

If you are separated from baby or are choosing to exclusively pump, I would recommend trying to pump within the first hour – but at least within the first three hours after birth. Hand expression can be a great tool as well if you aren’t able to access a pump right away. 

 

How Often to Breastfeed

After the first feed, aim to breastfeed your baby whenever they show hunger cues, such as rooting, sucking on their hands, or making sucking noises. Try to focus on your baby’s cues rather than a specific time on the clock. 

This helps establish your milk supply and ensures that your baby gets enough milk. Offer both breasts at each feeding, starting with the breast you ended on last. This can be adjusted depending on your individual circumstances. If you have any type of potential for low milk supply, this early stimulation of the breast is especially important. 

When you are in the hospital, hospital staff often requests that you write down the exact times you breastfeed and for how long. This is often part of their protocol, but I would recommend trying not to get too fixated on these time recommendations. I find that many new moms think that they are only supposed to nurse every three hours for 10 minutes on each side after doing this, and this can set you up for a lot of frustration. 

 

Finding Support in the Hospital

Lactation support in hospitals isn’t always consistent. Some hospitals have IBCLCs on staff, while others rely on nurses to help with breastfeeding. Regardless, even when there is a dedicated lactation team, they are typically assigned many moms, and the time they can devote to helping moms (especially those with complex issues) is typically minimal. 

Before you deliver, become familiar with your hospital’s options – how often lactation consultants are available, how long you’ll be able to talk with them, etc. You should also see if they have breast pumps readily available. If they do have pumps, they may only have a limited number of flange sizes so ordering your correct size before your baby is born is very important if you think you might need to pump. Your size may change after giving birth – and that’s where the Pumpin’ Pal sets can be beneficial because they come in various sizes and connectors. 

Regardless of your hospital’s offer, connecting with an IBCLC before you give birth can make a huge difference. Whenever I do a prenatal consult, I offer the family I’m working with the option to message me at any point after they give birth for additional support and virtual consultations. Having an IBCLC who you’ve previously met with and who is familiar with your goals can help you overcome any challenges you might encounter. 

 

Potential Issues You’ll Run Into in the Hospital

When you are in the hospital, there are some unique issues you might encounter that could cause issues with breastfeeding, including: 

  • Weight loss – all babies lose weight and sometimes it can be due to a lack of milk transfer. However, if mom received fluids during birth, this may artificially inflate the baby’s birth weight and make it seem like the baby has lost more weight than they actually did. 
  • Engorgement – it’s not uncommon to have some additional engorgement in the breast after giving birth. This can be from your milk coming in, but it can also be due to extra fluid from birth (that seems to cause a lot of issues, doesn’t it?!). Learning how to do reverse pressure softening and lymphatic breast massage can be really helpful to combat this. 
  • Timed feedings – most hospitals are trained to ask you to write down how often you nurse, the amount you feed, and the time you feed. While this isn’t inherently wrong, it can make you feel like you are only supposed to feed at a specific interval, which can be difficult as you are trying to feed to your baby’s individual needs. 

Seeking support from a lactation consultant can help you overcome these challenges and ensure a successful breastfeeding experience.

 

In conclusion, by knowing what to expect and seeking support when needed, you can navigate this exciting time with confidence and set the stage for a successful breastfeeding relationship with your baby.

 

Written by: Katie Clark, IBCLC (@thebreastfeedingmama)