Breast Feeding Plan - Suggestions / Comments

I should have done this before my last appointment but I thought it was going to be with an OB... ended up being with a midwife so I could have talked about it... but now I don't have another appointment before my little man arrives so I was wondering if you breast feeding mothers could give me a hand with comments and suggestions on my current plan...


• Skin to skin in theatre once baby cleaned up & weighed - Josh to support baby in place if shakes cause problems (The reason for cleaning up first is I won't be able to get up and shower at least until afternoon and would prefer to be uninterrupted skin to skin once started. )

• Skin to skin in recovery - Josh to support

• Once in room Josh to have cuddles skin to skin

• Constant skin to skin for first 4 hours with breast on offer as required (sounds like a milk bar nut means bare chested for baby to find)

• First sign of cracks (not sure how I'll know yet) I'll start using nipple shields (cracks HUGE last two attempts) – Although I read this morning that you shouldn’t use them until your milk has come in???

Still not sure if demand feeding or a routine to try and ensure I'm feeding enough is the better option.

I'm a little worried about making DH (Josh) feel left out so not sure on the constant skin to skin. Also I know my family (mum) will most likely visit as soon as possible and she will basically make me feel like crap if I don't let her cuddle if it's in those first few hours and those feelings aren't worth the pain so I'll end up giving in. My sister won’t be visiting until late afternoon by which time I’ll be happy to share cuddles.


Still to source information for:
Problems with left breast on last two attempts – ways to improve using this side (it doesn't leak at the moment like the right hand side does)

Reasons for it not working on earlier attempts
DS1 - Induced turned Emergency C-Section due to failure to progress - Milk didn't come in, two bouts of Mastitis in the first three weeks results in one 3 day hospital stay and one 12 hour hospital stay. Huge cracks, thrush, un-supportive partner (I drove 2 weeks after c-section to get formula at 10pm)

DS2 - Waters broke, planned c-section brought forward to that day - Milk arrived but still got cracked nipples :( - HEAPS of milk that I was :redface: throwing down the skin :redface: :wall: day 9 after his arrival ended up in hospital for 3 1/2 weeks with a severe infection, HEAPS of drugs, two more operations, drugs weren't good for milk supply and it dried up, was too weak to fight milk supply.


So any information or helpful hints would be greatly valued... I so want this... and I PROMISE not to throw anything down the skin :pray:

Have you had a nipple shield fitted? If you are going to resort to those make sure you have ones that fit YOU. They often do more harm then good.
Really look at your attachment/position if you are getting any damage at all.
I would put in your plan
FIRST SIGNS of nipple damage that the LC comes & helps assess whats causing it. Don't jump to nipple shields straight off. Make them help you figure it out as to WHY there is damage happening.

Oh and feed on demand with the idea of not going longer then 3 hours between feeds.

I didn't even know you could get ones fitted.

I've been referred to the LC at the hospital already so they will make an effort to come and see me once on the ward. And once I'm able to I will attend the hospitals educational class. I've watched lots of videos on attachment and book marked them so I can rewatch on my phone / laptop if need be.

You could also take bub to see an osteo. Sometimes breastfeeding issues can be about an inefficient suck, so they have to be on the nipple longer...

I found lansinoh to be great for cracks when they happened. Paying attention to attachment, especially when you are tired (this is when i got my damage) can help prevent/reduce getting cracks in the first place.

Have you seen the breastfeeding plan on the ABA site? Australian Breastfeeding Association - My Breastfeeding Plan

Good luck with it all!

DS barely fed at all for the first few days. i wish i was told to express more. it may have prevented mastitis and MAJOR blockages. it ultimately led to me stopping breastfeeing. :(
so theres my tip: if you have a sleepy baby for the first few days, that would rather sleep than eat, express.express.express.
i too, hope to be much better prepared next time

good luck!!!

Have you attended the ABA's breastfeeding class, or are you a member? Your local group may be able to provide a lot of practical and moral support.
Does your hospital have a lactation consultant on staff? Getting an LC to come and be with you while you feed can be invaluable, especially if you've had issues with cracks in the past, as this suggests the latch or your technique may need some adjustment. A good LC will watch you feed and make some suggestions. She can also advise you on different holds (sometimes trying a football hold helps with the dodgy side), nipple care, and even osteo recommendations and that sort of thing. If you don't have access to an LC at the hospital, I would strongly suggest finding a private one - meet her, make a plan together and arrange for her to visit you in hoospital for those early feeds. I'm thinking also you might need extra help after a c/s? I know after DD's birth and the pph I couldn't sit up and that first night DD's latch was terrible as she was also tired and I couldn't sit up to hold her properly, and I had to spend the next couple of weeks reteaching her.

Good luck!

HotI – I have already purchased some Iansinoh in preparation. I have been to the ABA site and yes I did see that plan… however it was a while ago, I couldn’t seem to find it yesterday when I was writing mine, will have a good read and add things.

Mummajj – I will keep in mind about the expressing if baby is sleepy, I’ve read that drugs have those kinda affects on little people.

MadB – No I haven’t attended a class or been able to become a member of ABA, our finances won’t allow it at this time which is why I thought I’d take advantage of the services they provide at the hospital while you’re an in patient. I have however added the ABA 24 hour phone number and will call on them if need be and find a LC if things get rocky. I’ve asked to stay in hospital until my milk has arrived so I’m hoping to be able tackle the attachment / hold issues before I leave. I used the football hold last time and plan on using it again. I watched a video yesterday about the baby led attachment and planning on trying that also.

Oh the other thing I will not be doing this time is taking different advice from different midwives on different shifts... I found last time that each midwife had a different technique... fingers crossed I will be able to get the LC in my room the day bub is born (he's scheduled for 9am) otherwise I'm thinking of using the technique applied in this thread A Perfect Latch

DO they have LCs there? THey are about a million times better than your average midwife (some of whom know next to nothing about breastfeeding unfortunately)
Could you start putting aside a little money each week that you would have to spend on formula if this doesn't work to put towards an LC or classes?
If you're private I guess you can stay as long as you want.

marcallen cream was the bomb for sore nipples.... (same as lansinoh. anything that is pure lanolin, really) make sure you get two tubes. one for home, one for the nappy bag ;)

They have a Breastfeeding Support Centre (Mater Mothers) and they say that they have LCs so I'm guessing so. They classes there after you've left are $80 but I think that after I've left if I still need help then I'll do an ABA so I get a membership also.

I'm not private unfortunately but after discussion with the midwife in my second to last appointment the type of dressing that will be used on my c-section might require me staying 4 - 5 days at least. She seemed to think my milk would arrive on day 4... but I'm not so confident as it didn't come in at all the first time... but I will stay as long as possible.. and if it doesn't come in I will just have to find the $'s for a private LC

That sounds good. So can you make an appoitnment to talk to an LC before you have your baby? I realise you're due to have him in a few days, but it's worth a try.
It's not possible to predict when your milk will come in, but it does generally come quicker with each baby. Sometimes with subsequent babies you don't get the engorgement either, but the milk still comes in, it's just that your breasts get more efficient over time (just something to be aware of).
Do you have a copy of Breastfeeding Naturally? It's a great resource for all things breastfeeding.

Just a thought

my dh had skin to skin contact with bubs before me... It certainly helped them to bond alot.....

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I didn't even know you could get ones fitted.

I've been referred to the LC at the hospital already so they will make an effort to come and see me once on the ward. And once I'm able to I will attend the hospitals educational class. I've watched lots of videos on attachment and book marked them so I can rewatch on my phone / laptop if need be.

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The LC should be able to make sure you have the correct size/shape for you. Its hard because I doubt anyone would have a set of all available to make sure you have the best fit for you. I will see if I can find anything to link you too that will help you with making sure you are getting a good fit.

Some great advice! I had 2 c/s, with my first my milk didn't come in until day 5 and it was awful waiting and DD had to be topped up with formula. With DS I didn't want it to take quite so long to come in if I could so the advice of demand feeding with no more than 3 hours between feeds was what we did, we also as of day 2 expressed after every 2nd feed during the day. About an hour or so after a feed and all through the night. The midwife would come in and I would be half asleep while she helped me hand express to give to DS if he needed it and also to bring my milk in earlier. It worked for me and it came in by the night of day 3. Talk to them about strategies like that, that you can do to assist with helping stimulate your supply - I was pretty tired but very determined not to wait 5 days. :hug:

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DS barely fed at all for the first few days. i wish i was told to express more. it may have prevented mastitis and MAJOR blockages. it ultimately led to me stopping breastfeeing. :(
so theres my tip: if you have a sleepy baby for the first few days, that would rather sleep than eat, express.express.express.
i too, hope to be much better prepared next time

good luck!!!

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Would have hospital supplied the breast pump or should I pack my manual one?

Breast Feeding Plan

• Skin to skin in theatre once baby cleaned up & weighed - Josh to support baby in place if shakes cause problems. Baby is to be placed under a blanket but bare on my chest (only wearing a nappy)

• Continue skin to skin in recovery - Josh to support

• I would like our baby to remain with me on my chest to encourage him/her to self-attach for his/her first breastfeed (with assistance from me as I feel is appropriate).

• If I am unable to hold our baby skin to skin after birth, I would like my partner to hold our baby until I am able. This is to be skin to skin, again under a blanket wearing only a nappy

• Once in our room Josh to have cuddles skin to skin

• Constant skin to skin for first 4 hours with breast on offer as required

• I wish to follow a demand feed approach but no longer than 3 hours apart, if baby isn’t interested then I wish to express to encourage my milk to come in

• If baby requires expressed milk I wish for it to be administered via a syringe, not a bottle / teat

• First sign of nipple damage I would like to arrange a visit from a lactation consultant to prevent further damage. Next step is to use nipple shields.



Problems with left breast on last two attempts – ways to improve using this side
• Use football hold
• Pay special attention to latching on to ensure that it’s correct

Start stimulating your nipples now. TO help milk come in try and and gently massage down your nipples to help get all that lovely colostrum out. With all my children I kept any colostrum I collected before birth to give to them, a syringe can be helpful for those precious few drops. Do this also once bub arrives. I know some women who ask their DH/DP to help in this area.

Lansinoh is fantatsic.

Fenegreek is used by many women to help increase milk supply naturally (taken as a tea). If you google it you will find heaps.

Regarding skin to skin, you are on the right track and the more the better. As much as dad will what cuddles get him to cuddle both of you for the first 24 hours so bub can stay on you. A wrap or sling can help keep bub high and warm and save your arms if your feeling tired. Try to avoid crotch carriers they are awful for bubs spine. Once bub is out don't let them wipe him down or wash him. All that lovely goo is important for his skin and helps keep his skin from getting too dry, this will help if he doesn't want to feed too much at first.

IF he is not a big feeder to start with keep on stimulating those nipples and practicing and expressing motion (top of boob downwards) to help get that milk going.

And most off all have DH or a friend play intervention for you. Keep well meaning people away for a day or two and let it just be you and dad and other children. This allows you all to get to know each other which helps things settle down and relax so you have optimal conditions for getting that lovely boobie feeding going.

Wishing you so much milky bliss for when your newbie arrives.

In a big hurry - but my BF'ing plan is below. I had GD and CS both of which can delay milk... and mine wasn't. She was born Fri arvo, milk in Sun evening. Think the expressing prior to birth helped then HEAPS of expressing post birth (as she couldn't attach at all prior to milk coming in when we used nipple shields). Will try come back later to post more. BF'ing plan below:

I am very keen to give our new baby the best chance possible to have exclusive breastmilk and to breastfeed given the contributing factors outlined above. I have expressed and frozen colostrum which we will use if she doesn’t attach or has low BSL’s.
In order to maximise our chances of breastfeeding success, we wish to do the following:
• Maximise skin to skin with myself and baby as much as possible.
• BSL’s and any other injections, measurements to be done whilst baby on me if possible.
• My frozen colostrum is stored in the SCN freezer, labelled with my name, the date and a number (representing the order of freezing, i.e. 1 = first batch frozen, please use first, 2 = use second etc).
• IF she requires any top-ups (my colostrum by first choice), please syringe or cup feed.
• Please do not give my baby a teat or dummy.
• Please do not give my baby formula without my consent. If formula is medically necessary, please use NAN HA or provide us with information as to the best formula to use to minimise allergy risk.
• Following the birth, we plan to allow her time to attach and act like a normal baby. If she doesn’t attach, and/or has low BSL’s (~2.6 or less), myself or my husband will give her stored colostrum (approx 1 ml, 2ml if bigger baby) while she is still skin to skin with me.
• If her first BSL is good (~4) then we hope to see if she will attach to the breast.
• I am aware that baby will be admitted to SCN for at least the first 24 hours, during that time would like her to room in with me as much as possible, if BSL’s are adequate and there are no other health issues.

I haven't had bubby yet. Just with the ABA class and membership it is very good value, even better if you have a concession card.

I paid $70 and that included the half day course, lunch, magazine subscription, Breastfeeding Naturally book. Being a member I can go to the local Mother's group for a year (you can visit twice if not a member), and I can get 10% off at the shop, and also discount breast pump hire, through either the local group or at the office at Coorparoo.

Another idea is you can get the book, there's older copies you can get on eBay if things are really tight.

I think your plan looks really good.

I would ask yourself a couple of things - you sound so determined to breastfeed, is being clean more important than this? I would go for immediate skin to skin if you can. Baby and you both have all the right smells, fluids and bacteria, not only to set up breastfeeding but to give baby the "right" bacteria for future health. I would avoid baby's first contact being hospital staff, equipment and towels if you can. They aren't that dirty ;)

Secondly - I think successful breastfeeding is mostly about support. If you can at all try and find a support group of mums who have btdt who can travel the road with you. Here in NZ, I'd be saying go to La Leche, but I'm not sure how the ABA groups work. Going while still preg so you meet them before problems happen is a good idea. Support from other mums is so valuable. Also though this includes support from your partner, and support from seeing an LC at the right time etc etc

Expressing if baby won't latch is a great one, and the not going too long before feeds. I had a horrid start with my first (we did get through it though and keep feeding, but sooo nearly didn't) so I had a similar plan for my 2nd, including the early use of nipple shields like you. I can give you a positive success story too - we had a much easier time with virtually no pain and only used the shields a handful of times! :D

I think it's just great you've got a good plan and are determined about making it work - those are the most important things! Good luck!

How are you going? I'm keen to know how the bf-ing is going for you and your beautiful bubba, I hope your nipples and attachment are all beautiful and wish you all the luck in the world!

My side of things are going very well, might have an issue with oversupply growing but trying to kick it in the butt before it really hits. Also I believe I have vasospasm which hasn't been helped by this cold weather.

Oliver has reflex which isn't as easy to manage while breastfeeding (he's my 3rd reflux baby but 1st breastfed) but we are getting there. He's putting on heaps of weight and generally a pretty happy baby :-)

You ladies and your suggestions & helpful advise has really made this journey a lot easier to handle. Thank you so much!!!!

I'm so pleased for you, you must be thrilled! I mean there are the bad points about reflux and vasospasm, but oversupply is one of the "problems" a lot of women would kill to have! Thanks for the big grin, I'm so happy for you :D