A few times a week I get asked what you can do prenatally to prepare for breastfeeding. If this is also your question, this blog is for you!
Skip to the section of interest:
Hand Expression
Choosing A Breastpump
Items to purchase (Now or Wait)
1. Hand Expression
This is a skill that every new parent should learn before birth. It is proven to improve the initiation and establishment of your breastmilk supply. It will also help you feel confident about your journey once you have it down. It gets you used to touching your own chest/body in this way, making it second nature after birth.
When you hand express in the early days postpartum, you can get more milk out than the pump. This is because the pump isn't as good as your hands manipulating and stimulating the breast to get your "first milk" out, colostrum, which is very thick and small in quantity but rich in quality being packed with all the unique essential vitamins, nutrients and minerals that nothing else this earth has or can create!
This is a very popular video on hand expression:
https://med.stanford.edu/newborns/professional-education/breastfeeding/hand-expressing-milk.html
It is very safe for most people. You want to avoid nipple stimulation that causes contractions. Learn this skill and practice it during pregnancy after 38 weeks, ONLY if you have NO risk factors or preterm labor. Doing so before 38 weeks with risk factors will increase your chances of premature birth.
If you would like to harvest or collect colostrum, you can do so and bring it to your birth location or have it in freezer for home birth.
You can actually hand express into a spoon, freeze that spoon with the colostrum on it and safely package it until time for use. When you are ready to use it, lay the frozen bottom of the spoon on top of some warm water to defrost, then you can spoon feed it to your newborn by letting them "lap" the milk off the spoon like a little puppy or kitten does with their milk. Syringes work as well. Be sure to label each one.
Many parents I work with have used these colostrum harvesting kits by Haakaa and I think they are great!
Here is a set with a Haakaa hand pump and colostrum tubes. (The hand pump is best used for capturing milk when you are breastfeeding not for initiating milk supply. You could wear it for 5 mins on one side while you nurse your baby on the other side. I like the Haakaa hand pumps the most for clearing plugged ducts with a trick that I teach and will show you in another blog.)
Lactation Hub also sells a harvesting kit with a baby feeding cup which is awesome for newborns and up.
2. Choosing A Breast Pump
Finding the right pump can be challenging given all the different options on the market. A few years ago there were like a dozen well known pumps, now there are well over 100 varieties and brands of pumps due to more manufacturers with more adding to the list every day. Pumps are not FDA regulated and therefore anyone can make and sell a breast pump. For this reason, they are not all created equal. You should use caution and do lots of research including checking them out in real life before getting yours.
Did you know?
Thanks to the ACA (Affordable Care Act) created by the Obama administration, your insurance may cover a quality pump, most do. If you qualify for WIC you may be able to request one for free if you are working or a student.
The biggest factor of choosing a pump is, how often will you be using it. Followed by, where you will be using it, what purpose is it being used, and lastly the aesthetic--many moms choose a pump strictly on how it looks or what they've seen TikTokers recommend but this isn't the smartest way to choose because one thing that we know is that everyone has a different body and the way your body responds to a pump may not be the same as the way someone else's body responds to that particular pump. What works for one doesn't work for all, and this is true for everything in life, especially parenting and baby products.
This is how I recommend pumps:
To increase supply or for exclusive pumping - A "hospital grade" heavy duty multi user double electric pump
Keep in mind, hospital grade is thrown on everything now days. Not all of these pumps are the same strength. When shopping for a pump that is hospital grade you mainly want to make sure it is
Here is a great trusted source for breast pump comparisons:
A one stop shop to find a good pump you can try The Lactation Network Shop. You should also check your insurance coverage with TLN (The Lactation Network) to see if you can book a prenatal or postpartum lactation visit with me through them!
3. Items to Purchase
Should you get it now or wait until after birth? Most things you will need to get after baby comes. There is no way to predict what you will need but most things you won't need right away. There is no point of wasting money on something you may never need or use, so it's best to figure out your individual situation before purchasing baby and breastfeeding items. I will give you a list of the most commonly asked about items and give you my opinion on whether you should get it now or wait.
Nipple Shield - Postpartum; Wait until postpartum AND advised to do so by a lactation consultant; be sure to ask for a plan of care to wean from it. Nipple shield use can cause decrease in milk supply. These are for very specific situations and should be used with proper guidance.
Breast Pads - Postpartum; Everyone doesn't leak, so there may be no need for these. If you want to purchase some consider buying a very small box or one pair of reusable ones until you know it's needed.
Supplements - Postpartum; Supplements do not produce milk, they simply can for some people enhance their milk supply with effective, frequent and efficient milk removal by feeding or pumping. You cannot just eat, drink or take a pill that will give you milk without regular stimulation of the breasts. Not all supplements are safe; some are harmful or you may be allergic or have a medical condition that makes it contraindicated for you. Some supplements are expensive so I wouldn't purchase it prenatally because it may go to waste if not needed. Always ask a lactation consultant, OBGYN or herbalist to help find the find one for you. Body armor doesn't create milk, it hydrates you, being hydrated is only one small part of lactation.
Bottles - Prentally; You can purchase these prenatally but I would also wait until after the first 2-4 weeks of life to do so. If you would like to buy bottles consider purchasing one that has a wide neck and one with narrow neck, but both should have a natural slope and not an exaggerated slope as that could be problematic for suckling. I would suggest only purchasing 2 bottles or requesting them on your registry. Tell people not to get what they want because then you will end up with ones you don't use. My favorite bottles at this time to recommend are Pigeon, Lansinoh, Dr. Browns, Evenflo Balance. Be sure to get only 4oz bottles, babies won't need more than that until after 6 months but at that point they can and should transition to a sippy cup. Also consider slow flow nipples, 0+ / preemie / 1 / 0-3 months, and keep that same flow the entire time they are on bottles. This will be helpful for reducing gas, reflux, flow preference and make it easier to go back and forth between breast and bottle.
Breastfeeding pillow - Prenatally; You can purchase this prenatally; keep in mind you don't necessarily need one; everyone doesn't love them or find them to be helpful. When I don't have one on a home visit, I just use their sofa and bed pillows which works just fine and most of the time easier and better, more convenient. At my clinic space, I use a Boppy and a Breastfriend. I prefer the Breastfriend pillow because it is flatter, firmer and easier to position the baby, rounder softer ones like the Boppy are a bit more tricky to use and can cause baby to kind of "fall" down into it or between you and the pillow. There are other brands now too, find what you like and works the best for you and baby if purchasing postpartum.
Nipple butter/cream - Prenatally; This is OK to purchase prenatally. I prefer organic nipple butter or cream like Mother Love. There are a ton on the market, find the one you like the best and be sure to check the ingredients. Lanolin is different from nipple cream/butter, and acts more as a barrier than a moisturizer. I don't love it but some people do, if this is you then use it. My go to solution for preventing nipple soreness or healing cracked nipples is coconut oil or breastmilk itself, sometimes a concoction of the two. For severely damaged nipples (bloody) I recommend Medi-Honey to my clients, do NOT use regular honey as that can be fatal to babies, but Medi-honey is a Manuka honey product that is sterile and has botulism spores removed. It is safe when on the breast for baby.
Nipple everter - Prenatally; this is OK to buy while pregnant and some will choose to use it while pregnant after 38 weeks to start "shaping" the nipple and get it used to coming out often. This is for if you have inverted nipple(s) that go "in" towards your breast/chest.
Breast Shells - Prenatally; this is also OK to buy while pregnant. Some people use these after 38 weeks for the same purpose as above, shaping the nipple if they have very flat nipples. Some people use these postpartum to keep clothing off sore nipples.
Breastmilk catchers - Postpartum; again, you may not be someone who leaks. These are not necessary until after birth. If you start to leak a lot you may wish to use these vs. breast pads to collect the milk rather than let it go to "waste".
Nursing/Pumping Bra - Postpartum; you can purchase on of these while pregnant but I would go a size up from what you currently are to allow for room for expansion of the breast tissue as you become engorged when your milk increases in volume. Your breast also may grow after birth and stay that size for a while. If purchasing postpartum, be sure to get one that feels good, and allows you to pump and feed like ones by Kindred Bravely, Momanda, MomCozy, etc. Be sure it is not too tight as that can restrict the milk from flowing through the ducts and cause plugged ducts, low supply or mastitis. Go wireless and avoid underwires!
Baby carrier - Prenatally; this wouldn't hurt to purchase while pregnant. If you are able to afford two, I would say purchase a non-structured wrap style carrier like Baby K'Tan, Moby, etc. but practice using it while pregnant and also a structured one that can grow with baby like a BabyTula or Ergo. The structured carriers are a bit easier to use but without proper inserts that sometimes come or don't come with it, they may not be suitable for babies under 7 or 8lbs. The wrap style carriers take practice but are very helpful for skin to skin with newborns. You may be able to find one that is pre-wrapped and easier to wear like a T-shirt style one. They are usually only able to be used for a shorter time period like 0 - 3 months while the structured ones can be used from 0 - 18 and sometimes 24 months!
Breast heating pads - Prenatally; A little warmth won't hurt to have in case of emergency for plugged duct removal. It is not totally necessary to buy the ones they make as you can create your own warming rice sock for this purpose but for the sake of convenience you can buy these. I like the ones by Lanisnoh and Frida mom.
Breast massagers - Prenatally; same reason to purchase as above, you can use this for plugged ducts. You can also use this to help move milk around in the breast or to increase your milk output when pumping or before feeding. I currently like the ones by La Vie Moms, because they have so many options from manual to warming to waterproof for shower. But they have tons of these massagers on the market now so choose whichever one you like.
Milk storage bags - Postpartum; find ones that are BPA free. Reusable ones are great but not if you will not have time to clean them. I like the disposable ones by Kindred Bravely, Lansinoh, Medela. They are all sturdy as to not tear and create leaks and they are BPA free. Again, there are tons of breastmilk storage bags on the market so choose which one works best for you. I hear the up&up brand is pretty good too though I haven't tried them myself. You will not likely need storage bags until you are pumping or after the first week or longer. If you are a NICU parent, you will likely need sterile bottles not bags for proper storage for premature babies.
Silverettes - Prenatally; have these on your registry. These can be used for multiple pregnancies/postpartum experiences. So if you plan to have more than one child these are a keeper. These silverettes work to soothe sore nipples and heal damage with the silver that is in them. I highly recommend them for parents with very sore and cracked nipples. You wear them like breast pads. Many clients love them, although they are a bit pricey. The cheapest I've seen them is $33. There is the primary brand Silverettes and then there are generic, both are fine.
Wearable pump - If you are going to be an exclusive pumper, then this will just be an extra pump not your main pump. If you plan to pump only occasionally or only at work, then this could be your main pump. Although, I still recommend the heavy duty multi user pump for those who will be doing a lot of pumping or need to increase their milk supply. Not all pumps are created equal, find the one that your body responds to the most and most of all purchase inserts to go in your flanges to ensure your wearable pump fits well for good milk production. Most people are around a size 15/17mm and most pumps unfortunately come with a 24, 27 or smallest 21mm. The wearable pumps come in wireless and wired options. I like the MomCozy S12 Pro the most right now in terms of it working for most people and being pretty affordable if buying out of pocket. The Elvie and Willow are very pricey and I've had too many clients have issues with them so I can't wholeheartedly recommend them at this time, but I hope that changes in the future.
Nursing cover or clothes - Prenatally; You can purchase these while pregnant but keep in mind your breast may continue to change and grow while postpartum. There are regular clothes you can use to make your breasts more easily accessible like a low cut top or tank. You could also try the two shirt method, The 2-shirt method makes it incredibly easy to feed in public. Pull up your top shirt, pull down your under tank or shirt, latch your baby. However, some people like the convenience and style of nursing clothes and that's OK too! If that is you I highly recommend you check out Kindred Bravely as well as Undercover Mama, The Little Milk Bar, Big Milk Energy Co., Target Maternity has a few lines there too. Nursing covers are a personal preference, if you want it for modesty then by all means. If you are Ok with nursing in public without one, more power to you! A muslin fabric baby blanket works too.
Hand pump - Prenatal must have! I love a good fitted hand pump! These are great at getting out milk in the early days postpartum, for many people they get more milk out that with an electric pump. It's also great to keep one in your car, diaper bag or work desk for emergencies. Batteries die, technology fails so sometimes you just need to get handy. Hand expression is a valuable skill but if that isn't your thing, this is a close second best. Medela and Lansinoh both have one. The Haakaa hand pump is a passive pump, meaning it's better for collection than hands on pumping, but some have been able to use it that way. Find whatever one you like and give it a go! Practice using it after 38 weeks, you may be able to express colostrum with it. Be sure it fits properly, if not purchase a flange for it that does fit you. Use the flange fitting ruler below. Keep in mind, most people are around 15/17mm, so that could be a good place to start if the standard one it comes with doesn't seem to fit, meaning nipple is not touching the sides of the tunnel.
Free Flange Fitting Ruler (Printable)
https://www.melaninmilksd.com/post/flange-size-matters-how-to-make-more-milk
A place to purchase items you may be having a hard time finding besides Target and Amazon, is Lactation Hub, this is where many of us lactation consultants get items, it is open to the public for purchasing.
A bonus tip!
You can add early chest/breastfeeding goals into your birth plan to make your experience more positive and get off to a good start for a successful chest/breastfeeding journey. Things like skin to skin, delaying eye ointment and bath, what to do if you have a c-section, pumping, etc.
I offer birth planning services!
You can be anywhere in the world. This is a virtual appointment only. It includes a customized final birth plan in digital format provided to you within 7-10 days of our visit. I go over this and more with you when we create a birth + breastfeeding plan specifically to help you meet your goals. This can also be discounted as part of a package if you take a childbirth or breastfeeding class with me.
I will soon be offering a FREE breastfeeding prep class!
I teach on the practice and uses of hand expression, how to prepare for lactation, and an overview of all infant feeding methods. We also debunk or validate tips and advice seen on TikTok, YouTube, Instagram and Facebook to help you make informed decisions and better navigate the wild world of parenting through social media. Link for this coming soon, check back later on this blog for update or my website or social media.
Course includes:
What is hand expression and what is needed for it?
Why and when would you want to hand express? How lactation stages change, expectations with your body in the early days to established?
Building confidence with chest/breastfeeding
Short term goal setting for a successful journey Learn how to create an infant feeding plan most compatible with your lifestyle, family and culture
That's all I have for you in this blog, stay tuned and following for more tips!