Prenatal Discussion about Breastfeeding

Prenatal breastfeeding education:

• has the biggest effect of any single intervention on improving breastfeeding initiation and duration rates

Medical providers’ attitudes about breastfeeding:

• significantly impacts breastfeeding rates
• if medical providers have a positive attitude and encourage breastfeeding, mothers are much more likely to initiate breastfeeding

How to talk to pregnant mothers about breastfeeding

There are many effective methods to educate mothers prenatally about breastfeeding including structured group and individual classes.

Brief prenatal discussions using the “Best Start” technique also have been shown to increase breastfeeding rates.

• If you are an OB/GYN, you can use the “Best Start” technique during a prenatal visit
• If you are a pediatrician, you can use this interviewing technique during either a prenatal visit with the family or when you notice a mother is pregnant during a sick or well child appointment with one of her other children.

Best Start Technique:

1. Ask:
   • Ask open-ended questions such as “What have you heard about breastfeeding?” instead of “Are you going to breast or formula feed?”
2. Acknowledge:
   • Acknowledge the mother’s specific concern.
   • If she says she heard “breastfeeding hurts” then acknowledge her concern by saying “so, you’re concerned that breastfeeding is going to hurt you.”
3. Advise:
   • Advise the mother specific to her concern.
   • For example, you could tell her that “you may feel discomfort for the first week or two when the baby first starts nursing, but breastfeeding should not be painful. Many women don’t get the help they need after the baby is born, so the baby doesn’t latch-on correctly. If your baby is in the correct position and opens his/her mouth widely, breastfeeding should not hurt. It is important to get help in the hospital from someone knowledgeable about breastfeeding and see your pediatric provider a few days after you leave the hospital”

It would be ideal to also discuss with the family the importance of:

• The baby breastfeeding as soon after birth as possible (preferably in the first hour).
• Avoiding supplementation with formula unless medically indicated.
• Knowing the signs of adequate milk intake.

Your role as a medical provider is crucial in promoting and supporting breastfeeding.