It's best to take a breastfeeding class in your third trimester (28 weeks and beyond), and ideally after you have taken another class on childbirth to better understand how labor and birth can affect breastfeeding.
Classes are about 10-15 minutes each and cover topics like the basics of breastfeeding a newborn, life with a breastfed baby and the breastfeeding lifestyle.
Place your baby in one of the breastfeeding positions (outline below). Put the thumb of your free hand on top of your breast and your other fingers below. Touch your baby's lips to your nipple until your baby opens their mouth wide. Put your nipple all the way in your baby's mouth and pull your baby close to you.
Compared with formula, the nutrients in breastmilk are better absorbed and used by your baby. These include sugar (carbohydrate) and protein. Breastmilk has the nutrients that are best for your baby's brain growth and nervous system development.
This course is designed to provide quality and current information about the benefits and challenges of breastfeeding so that healthcare professionals can assist lactating women in making and reaching breastfeeding goals.
Exclusive breastfeeding is defined as ONLY breast milk—NO solids, water, or other liquids. The Healthy People 2030 objectives for breastfeeding include increasing the exclusivity rate at six months to 42.4% and increasing the percentages of infants breastfed in any capacity at 12 months to 54.1% (ODPHP, n.d.).
Lactogenesis is the process by which alveolar cells mature and secrete milk (Figure III). Lactogenesis I, or secretory initiation, begins around 16-20 weeks gestation. The high levels of progesterone supplied by the placenta help mature the epithelial cells of the alveoli, and colostrum secretion begins in small amounts. Some women can even leak or express colostrum before delivery, though the ability to do this has nothing to do with breastfeeding success after delivery. Once the placenta is delivered after birth, there is a sharp drop in progesterone levels, accompanied by an increase in prolactin, cortisol, and insulin which stimulate lactogenesis II, or secretory activation, and the body begins to make an increased (and often overabundant) supply of milk around 2-3 days after delivery. Lactogenesis II may be delayed slightly in women who have never lactated before, resulting in a lower initial milk volume or closer to 3-6 days for full milk volume to come in; this is completely normal. This process may be interrupted by anything that disrupts the hormone response following delivery, such as retained placenta fragments, cesarean deliveries, diabetes, or difficult vaginal deliveries. Lactogenesis I and II are hormonally driven and occur whether a woman chooses to breastfeed her baby (Pillay and Davis, 2020).
The most current data regarding breastfeeding rates in the United States, from 2017, indicates that 84.1% of infants are breastfed at some point after birth, but only 58.3% of those infants are still breastfeeding at six months and 35.3% at one year (CDC, 2020).
All breastmilk comprises some combination of proteins (whey and casein), fat, vitamins, and carbohydrates. The exact composition changes as the baby grows and even changes throughout the day or within the same feeding, depending on the baby's needs. During the first few days of life, babies receive colostrum which is dense in calories and antibodies. Only small amounts of colostrum are needed to fill a newborn's small stomach and meet their nutritional needs with each feeding. It is easily digested and acts as a laxative to help clear meconium from the baby's intestines (La Leche League, 2018b). Over the first few weeks of life, breastmilk transitions to be thinner and primarily carbohydrate-based. Nighttime milk has been found to have higher fat content than milk produced during the day and contains tryptophan and melatonin, which helps the baby develop a more regular sleep/wake pattern (Tilman, 2015).
Breastfed infants also require around 15% fewer visits to a healthcare provider each year, freeing up valuable and limited healthcare resources. The reduction in rates of obesity, cancers, and diabetes has a similar effect, using up fewer resources and producing less strain on the healthcare system (La Leche League, 2020).
On a global scale, the World Health Organization (WHO) and United Nation's Children's Fund (UNICEF) has developed guidelines for the Baby-Friendly Hospital Initiative (BFHI), which aims to increase breastfeeding rates by ensuring healthcare facilities have the knowledge and tools in place to provide the information and help women need to breastfeeding successfully. Since many women begin their breastfeeding journeys at hospitals and birthing centers, it seems these are the best places to reach them and promote breastfeeding.
Many first-time parents have never cared for a newborn. Hospitals, community education centers, and places of worship sometimes offer baby care classes. These classes cover the basics, such as diapering, feeding, and bathing your newborn. You also will learn these basic skills in the hospital before you are discharged.
Like any new skill, breastfeeding takes knowledge and practice to be successful. Pregnant women who learn about how to breastfeed are more likely to be successful than those who do not. Breastfeeding classes offer pregnant women and their partners the chance to prepare and ask questions before the baby's arrival. Classes may be offered through hospitals, breastfeeding support programs, La Leche League, or local lactation consultants. Ask your doctor for help finding a breastfeeding class in your area.
Currently, the World Health Organization (WHO) recommends that a child breastfeed exclusively for six months, and then continue for at least two years with the introduction of complementary foods to the diet (WHO, 2019a). The American Academy of Pediatrics agrees that infants, with rare exceptions, be exclusively breastfed for approximately six months with continued breastfeeding along with the introduction of complementary foods for at least one year (The Centers for Disease Control and Prevention, [CDC] 2018b).
Healthy People 2020 targets for exclusive ly breastfeeding are 46.2% at three months and 25.5% at six months.
Common problems faced by breastfeeding mothers include plugged ducts, sore nipples, engorgement, mastitis, low milk supply, and fungal infections. Plugged ducts. A plugged duct occurs when a milk duct does not drain properly, causing pressure to build up within the duct and inflammation in the surrounding tissue.
In 1971, only 24.7% of American women discharged from the hospital were breastfeeding. Since then, breastfeeding initiation rates have progressively increased due to active initiatives (The American College of Obstetrics and Gynecologists [ACOG], 2017).
Feeding cues. It is crucial to identify feeding cues for when the infant is ready to breastfeed: When babies are hungry, they are more alert and active. They may put their hands or fists to their mouths, make sucking motions with their mouth, or turn their heads looking for the breast.
Signs and symptoms of mastitis may include: Breast tenderness and warmth, Breast swelling, Thickening of breast tissue, Pain or burning sensation continuously or while breastfeeding, Skin redness, possibly in a wedge-shaped pattern, Yellowish discharge from the nipple resembling colostrum,
Some women have difficulty producing enough breast milk after a complicated labor, delayed initiation of breastfeeding, separation due to the baby being preterm, formula substitution, cracked nipples, or maternal illness. The nurse should offer a referral to a lactation consultant who can assist with breastfeeding.
As trusted health advisors, physician support and management of breastfeeding is important to help families meet their breastfeeding goals.
The Project Advisory Committee (PAC) consisted of breastfeeding subject matter experts and key representatives from the following organizations:
American College of Obstetricians and Gynecologists (ACOG) American College of Osteopathic Pediatricians (ACOP) Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) of undergraduate and graduate medical education to guide the development of breastfeeding education and training for physicians.
Improve capacity of medical providers to:#N#Facilitate safe implementation of evidence-based maternity care practices at the hospital level and within their practices#N#Promote continuity of breastfeeding-related care in their communities. 1 Facilitate safe implementation of evidence-based maternity care practices at the hospital level and within their practices 2 Promote continuity of breastfeeding-related care in their communities.
But research shows that physicians generally lack adequate breastfeeding education and training. Better training in this area can help them gain the appropriate knowledge, skills, and confidence to support families and advocate for breastfeeding-friendly practices where they work. .
The Center for Breastfeeding has the expertise to meet your career and personal development needs with a wide range of lactation training programs.
This interactive course provides the opportunity to qualify for an advanced certificate in lactation management while verifying the insight, knowledge and skills essential to the development and implementation of management strategies for complex problems related to breastfeeding and human lactation. Participants will examine actual challenging cases, and develop management strategies using knowledge of psychology, sociology, infant development, gender studies, professional interrelations and ethics.
The Lactation Counselor Training Course is a comprehensive, evidence-based, breastfeeding management course with a strong focus on clinical counseling and assessment skills. Participants build on theoretical foundations to gain practical skills and verify competency as well as optimizing their ability to solve basic and complex clinical breastfeeding issues. This college level course prepares participants for professional work in the hospital, in public health, and community settings. At the end of the course, participants who have completed all competencies may sit for the CLC® examination, the premier national certification in lactation management for the United States, which is administered by the Academy of Lactation Policy and Practice (ALPP).
This foundation course for community workers in maternal child health focuses on providing services to pregnant women to encourage the initiation and continuation of breastfeeding. Strategies are presented for providing anticipatory guidance and support in order to prevent breastfeeding problems as well as to address barriers to breastfeeding in order to enable women to overcome any perceived or actual breastfeeding problems.