Breastfeeding Support - Prenatal

Family breastfeeding support and education should start before the birth of the baby. The role of the prenatal care provider cannot be understated. Prenatal education should be completed by 34 weeks and information can be provided throughout gestation as indicated below (source: ABM Clinical Protocol #7).

Provider Resources

Topic 1- Respectful Maternity Care (RMC)

White Ribbon Alliance
WHO Recommendations on RMC
White Ribbon Alliance Respect Campaign

Topic 2- Non-pharmacologic pain relief methods during labor and childbirth

InfantRisk Center: 806-352-2519 M-F 8AM-5PM
LactMed
ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017

Topics 3-8

TexasTenStep.org
Ten steps to successful breastfeeding (revised 2018), WHO
Baby Friendly USA
Breastfeeding Curriculum, AAP
Breastfeeding Management Training

Patient Resources

BreastmilkCounts.com
TexasWIC.org (online classes)
Getting Prepared, Breastmilkcounts.com
The Hospital Experience, Texas WIC (PDF)

Model Schedule for Prenatal Education Topics

Adapted from ABM Protocol #7, Model Hospital Policy (PDF).

Baby-Friendly USA requires topics to be covered in first trimester.

Topic 1. The right to receive respectful maternity care – which refers to care organized for and provided to all women in a manner that maintains their dignity, privacy and confidentiality, ensures freedom from harm and mistreatment, and enables informed choice and continuous support during labor and childbirth.

Topic 2. Pain relief methods during labor and the influence of delivery methods on breastfeeding success.

Topic 3. Global recommendations and importance of breastfeeding the importance of exclusive breastfeeding for the first 6 months, the risks of giving breast milk substitutes, and the importance of continuing breastfeeding after 6 months with appropriate complementary foods, for the first two years or beyond.

Topic 4. The importance of immediate and sustained skin-to-skin contact after birth.

Topic 5. The importance of early initiation of breastfeeding and rooming in on a 24-hour basis.

Topic 6. The basics of milk supply and demand, to ensure the infant’s adequate nourishment.

Topic 7. The basics of good positioning and attachment and recognition of feeding cues.

Topic 8. Management of most common initial challenges such as pain, cluster feeding, sleepy newborns, latching issues, engorgement and practice of safe sleep

Ten Steps to Successful Breastfeeding

The World Health Organization and UNICEF have outlined a bundle of evidence-based practices known as the Ten Steps to Successful Breastfeeding as a strategy to improve breastfeeding rates and health outcomes.

In Texas, the Health and Human Services Commission (HHSC) offers the Texas Ten Step program designation as a way for birthing facilities to improve breastfeeding rates across the state.

If you are a community-based clinical provider or provide lactation support in the community setting, you too have a role within the Ten Steps framework.

Step 2- education for staff, Step 3- prenatal care and Step 10- discharge support demonstrate how you can best support, promote and protect breastfeeding and breastfeeding families.

Visit TexasTenStep.org for more information on how to improve your care.

References and Clinical Guidelines

Clinical Guidelines

Holmes, A. V., McLeod, A. Y., & Bunik, M. (2013). ABM Clinical Protocol #5: Peripartum breastfeeding management for the healthy mother and infant at term, revision 2013. Breastfeeding Medicine, 8(6), 469–473.
Rosen-Carole, C., Hartman, S., & Academy of Breastfeeding Medicine (2015). ABM Clinical Protocol #19: Breastfeeding Promotion in the Prenatal Setting, Revision 2015. Breastfeeding Medicine, 10(10), 451–457.

References

Campbell, S. H., Lauwers, J., Mannel, R., & Spencer, B. (2019). Core curriculum for interdisciplinary lactation care. Jones & Bartlett Learning.
Lauwers, J., & Swisher, A. (2015). Counseling the nursing mother: A lactation consultant's guide (6th ed.). Jones & Bartlett Learning.
Lawrence, R. A., & Lawrence, R. M. (2016). Breastfeeding: A guide for the medical profession (8th ed.). Elsevier.
Lumbiganon, P., Martis, R., Laopaiboon, M., Festin, M. R., Ho, J. J., & Hakimi, M. (2016). Antenatal breastfeeding education for increasing breastfeeding duration. The Cochrane Database of Systematic Reviews, 12(12), CD006425.
Pitts, A., Faucher, M. A., & Spencer, R. (2015). Incorporating breastfeeding education into prenatal care. Breastfeeding Medicine, 10(2), 118–123.
Radoff, K., & Forman, R. (2019). Lactation Education for Resident Obstetricians: Promoting Breastfeeding Advocates for the Future. Journal of Midwifery & Women's Health, 64(6), 754–762.
Rodriguez Lien, E., & Shattuck, K. (2017). Breastfeeding Education and Support Services Provided to Family Medicine and Obstetrics-Gynecology Residents. Breastfeeding Medicine, 12(9), 548–553.
Rosen, I. M., Krueger, M. V., Carney, L. M., & Graham, J. A. (2008). Prenatal breastfeeding education and breastfeeding outcomes. MCN. The American Journal of Maternal Child Nursing, 33(5), 315–319.
Walker, M. (2017). Breastfeeding management for the clinician: Using the evidence. Jones & Bartlett Learning.

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