Preparing for Breastfeeding during Pregnancy

Congratulations – you’re going to be a mom! Or perhaps you’re going to be a mom again. Either way, almost as soon as the pregnancy test comes up positive, you’ll be confronted with the question: are you going to breastfeed? If you haven’t quite made up your mind yet, check out these posts on why breastfeeding is really worth it.

In practice, I find that most women are keen to breastfeed and most start out with breastfeeding – but at the end of the day, most of them don’t keep it up for long. And the numbers agree: the 2003 South African Demographic and Health Survey, the most recent large national survey that examined breastfeeding rates, found that by the age of 4-6 months, only 1,5% of South African children are still exclusively breastfeeding. Some smaller surveys done in the meantime have started to show an increase, but all in all there’s still a large difference between the number of women who intend to breastfeed and the number that actually manage to.

So in the real world, most women do not meet their own breastfeeding goals. Now, if you’re anything like me, you’ll want to know what you can do to maximize your chances of success. The good news: help is here! Starting from today, you can begin to prepare yourself for a successful, enjoyable breastfeeding experience. This post will give you a game plan so that you can put everything in place that you need to before your baby is born.


Preparing your breasts for their new role in life

On the subject of getting your breasts ready for breastfeeding, I have some very good news: your body does all the work for you! From early in pregnancy you may have noticed changes in your breasts – perhaps they got larger, or felt a bit tender. This happens because the breast is preparing itself to start making breast milk.

The breasts actually start preparing to lactate from as early as the teenage years. During puberty, the milk-producing tissue of the breast starts to form – small, non-functional milk glands and ducts form in the growing breast. During pregnancy, the change in the body’s hormones causes these little glands to go into overdrive: they start growing and multiplying, so much so that the size of the breast is noticeably increased – you may need some new bras!  About halfway through the pregnancy, these newly formed glands start to produce the first milk, or colostrum.

pregnancy breast development

How the breast develops during pregnancy

Your breasts may actually look quite alien to you during pregnancy:

  • The breast itself can look larger, with large blood vessels clearly visible just below the skin. This increased blood supply is providing nutrients for the breast itself and for milk to be made.
  • The nipple and areola (that dark area around the nipple) may become darker and larger
  • The areola may develop prominent little bumps called Montgomery’s glands (they can look like small pimples on the areola – do not try to squeeze them!) The Montgomery glands secrete oils that moisturize the skin of the nipple – that’s why it’s not necessary to apply nipple cream during pregnancy.

Despite what many of the older women may tell you, it is not necessary to “toughen up” the nipples for breastfeeding. Doing things like putting alcohol on the nipple or scrubbing it with a facecloth or brush will only injure the skin and ensure that you have sore nipples before you’ve even started.

Many nurses and doctors still like to teach pregnant women to do nipple rolling exercises, especially if they think your nipples look flat. There is no evidence in research that this helps: studies have shown that it is pregnancy itself that makes the nipples more elastic. If you want to do the rolling exercises, it probably won’t do any harm, but do be careful that you don’t damage your nipples in the process.

Knowledge is power

In all honesty, the most important thing to do while you are pregnant is to learn as much as you can about breastfeeding. When breastfeeding doesn’t work out, it is too often because the mom didn’t know any better and followed the terrible advice of a doctor or nurse who knew nothing about breastfeeding. Do not let that happen to you! A few topics you should learn about before you give birth are:

  • How different types of birth and labour interventions affect breastfeeding
  • The importance of early skin-to-skin contact
  • How to help your baby latch properly, including different ways to position your baby to breastfeed effectively
  • How to know whether baby is suckling well
  • How to know whether baby is getting enough milk
  • How normal breastfed babies behave (here’s a clue: it’s very different to how formula-fed babies behave!) – this is important so that you don’t panic about normal things like frequent feeds, cluster feeding, sleepless nights and growth spurts
  • Who to call when you need help

You will find some of this info on this blog, and I’m constantly adding more, so this is a good place to start learning. Also check out the resources page for other websites, books and organizations you can trust. I also strongly recommend hooking up with La Leche League during pregnancy – if there’s a group in your area, try to attend a meeting or two before you give birth, or otherwise join the La Leche League South Africa Facebook group. LLL is a great place to learn about breastfeeding from moms who have actually done it.

Setting up the birth you want

Some of the most important decisions you will make during pregnancy concern the type of birth you want to have. Every single thing that happens during the birth of your baby will affect how easy it is for you to start breastfeeding – and the easier the start, the easier the rest of the journey. I will leave the details of how every aspect of the birth affects the breastfeeding journey for another post, and only mention two things here:

Firstly, please do not rely on your gynaecologist to help you select birth options that will support breastfeeding. With rare exceptions, gynaecologists are not trained in breastfeeding support and are unaware (or don’t care) how birth practices affect breastfeeding. Do your homework before the time, so that you can judge whether those seemingly harmless interventions suggested by your gynae are really worth the risk.

Secondly, remember that the birth is only the first chapter in your breastfeeding story. And even if everything goes wrong on page one, the story can still have a happy ending. I have seen women breastfeed successfully after the most horrendous birth complications – you just need to have the right help available. So whatever happens, please don’t give up!

Some essential shopping

Ah the shopping list. It seems everywhere you look, you see a list of things that you absolutely must have for your baby. In this respect, breastfeeding is a lot kinder on you budget: all you need are breasts, and you already have them. In some cases, you may find it helpful to have one or two extra things:

  • Breast pads are useful if you tend to leak. I prefer re-usable cloth ones, simply because I hate throwing money in the dustbin, but disposable ones work well too.
  • If you plan to continue to work while still breastfeeding, you may need a breast pump. However, you don’t need to buy one until closer to the time; be sure to check out my posts on breastfeeding while working
  • A breastfeeding cover may be useful if you’re shy to breastfeed in public. Personally I’ve never owned one – I just used a receiving blanket if I wanted to cover up.
  • Nipple cream: occasionally useful, although most cases of sore nipples won’t be solved by nipple cream. Again, I personally never used it.

And the most important thing:

If I can name just one thing that you must have in order to breastfeed, it’s determination. Decide that you will do what it takes, and you won’t let anyone stand in your way. Arm yourself with knowledge, set your eye on the goal and run with it.

You can do this.


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