Mythbuster 4: Prepare your nipples for nursing

If you spend any amount of time on Facebook groups for nursing moms, you are bound to encounter a post such as: "I'm 7 months pregnant and my aunt has been telling me that if I'm going to be successful at breastfeeding I need to prepare my nipples now. What did you do to prepare?" And then the advice that follows ranges from "I scrubbed my nipples with a washrag daily, and I had no problems with nursing!" to "NOOOOOOOOOO, DON'T DO IT!!!!!!!" I've also heard women talk about pumping while pregnant to prepare in advance. So let's go over these suggestions, and talk about what you CAN do to prepare in a way that will set you up for breastfeeding success.

Let's bust this myth upfront. Your breasts are preparing themselves for your breastfeeding success. Scrubbing them to toughen them up is actually counterproductive. During pregnancy your nipples begin to create protective substances that make nursing more comfortable. If you scrub them, you actually scrub those substances off. So don't scrub!!!! Not only does scrubbing your nipples take away that protective barrier, it can actually cause infections. Then you go down a road of trying to clear that up before baby is born. When the latch is correct, the contact on your nipples is actually very minimal while breastfeeding. If there is damage to your nipples while nursing, that is similar to what would incur from rubbing your nipples-- then seek out help from a professional. Your nipples will need to adjust to their new job, and in the best of circumstances there may be some discomfort, but any visible damage is indicative of a problem-- most likely a less than ideal latch.

What about pumping then? Again, there's no reason to do this (at least as preparation for breastfeeding). There is no research which indicates that pumping while pregnant increases milk supply once the baby is born. Doing so probably won't damage your nipples like rubbing them will, but pumping is not breastfeeding. The mechanism is different, and you will learn nothing about positioning and latching baby by pumping. Some health care providers will suggest women use a pump as a form of nipple stimulation to try to induce labor after 38 weeks (if the provider feels like the baby should come sooner rather than later for some medical reason), but that is not to prepare for breastfeeding.

So, you're pregnant and you want to be as ready as possible for breastfeeding. You've heard so many stories of women who attempted to breastfeed but did not reach their goals. Maybe this is a second or third pregnancy for you, and you really hope to meet your goals this time. So what can you do?

1. Find support now. If this is something that is really important to you, then find people who will support your efforts. Breastfeeding can be challenging, and just like any other challenge that you might encounter, you might have to work through the struggles before it gets easier. If you think that work is worth it, then find people who understand that. Just like I wrote in a blog about unsolicited advice, make sure to share your breastfeeding struggles with people who will be supportive, and not with those who will push you to abandon your goals. Most breastfeeding peer support groups such as La Leche League International or Breastfeeding USA gladly welcome pregnant women in their monthly support groups. It's a great place to hear the struggles and solutions given to currently breastfeeding women and to meet a tribe of women who are also working towards meeting their own goals. These are great places to get recommendations for compassionate and knowledgeable lactation experts who can provide help once the baby is born. Many large hospitals also offer weekly support groups put on by a local IBCLC. Know which hospitals offer this so that you know where you can go if things are tough. Sometimes knowing that there is somewhere you can go in just a few days to get someone to look at your latch, or weigh the baby before and after a feeding to see how much was transferred can be the thing that keeps you from giving up when you're in the thick of it.

2. Know which trusted internet resources you will use. We all know that randomly googling any particular issue will provide you a wide range of contradictory advice. Online breastfeeding support groups can be great, but often the advice is always "your baby has a tongue tie" orsomething similar, and those giving the advice are other nursing moms who have limited expertise. Some of my favorite expert resources online are sites which take vast bodies of complicated research and break it down for those of us who don't have that kind of time. The website www.kellymom.com is one such site which has articles written by category, and which is often adding new articles. I often refer moms to various articles here when being asked questions related to breastfeeding. Another trusted breastfeeding site is overseen by Dr. Jack Newman who is a world renown breastfeeding expert based in Canada. His entire site has many great resources, but I find his videos to be really great. Sometimes reading about a particular position is not enough, we need to see a visualization to understand fully. Facebook groups that I find to have knowledgeable posters are the one run by an Australian IBCLC called The Milk Meg, and the group from my local chapter of Breastfeeding USA. I find the advice from these groups to be spot on, and there are not so many posts a day that they are hard to keep up with.

3. Learn about "The Magical Hour", and adjust your birth plan accordingly.  This could be the thing that MOST sets you up for a successful breastfeeding relationship. Your baby really does need to go through these 9 stages in her own time in order to be most prepared to breastfeed, and if we leave babies to do their thing in the first 1-2 hours, the likelihood that mom and baby will meet their breastfeeding goals increases. Make sure your care provider knows that unless there is a true emergency which requires you to be separated, you want AT LEAST one hour, if not two, of uninterrupted skin-to-skin time with your baby. Talk over what skin-to-skin looks like at the place you will be giving birth. Many hospitals promote immediate skin-to-skin care, but actually take the baby to weigh, measure, clean and check over before the baby has completed all stages and has breastfed. This takes at least an hour, sometimes more, especially if the mother was medicated during the delivery. If for some reason the baby does need to be tended to away from you, allow the baby to start the nine stages from the beginning once she has returned to you. In fact, if once you go home you realize that the latch is less than ideal, you can try to start the nine stages over! At a time close to when the baby might show signs of hunger (but hasn't yet), get in a warm bath, get cozy with the baby on top of you and let him have a do-over. This can sometimes correct a bad latch that is occurring because of bad positioning, or because the mom is helping too much!

4. Set up a nursing station, and prepare to do nothing but nurse for the first few weeks. As someone who is currently pregnant and running after a three year old, I almost laugh at my own advice. But this initial time is so important for bonding with baby, for figuring out the best positions for both of you, and for establishing your supply. Hopefully I will have some friends and family around that can entertain my pre-schooler, but at times when it will just be the three of us at home I am hoping to include him as much as possible. I'm already talking about how he can be a big helper once I'm nursing the baby all the time, bringing me things I need, reading to us, singing and dancing for us. I'm also going to set up his train tracks near where I nurse so we can be in the same room and he can talk to me about the various scenarios happening with his trains while I focus on feeding the baby and establishing that connection. And, if that doesn't work (some of you more experienced moms might be laughing at me right now), he might watch a little more Chuggington than I would prefer. Regardless of whether you have other children to care for or not, set up your nursing spot. Keep a water bottle there, have a phone charger, have a basket of snacks, get a stack of cloths or rags. Make sure it's super comfortable, allows you to prop up your feet, and allows for nursing in a variety of positions. You might need lots of pillows initially as you're figuring everything out. And use this time to stare at that baby and RELAX. The hormones that are released while nursing make both you and baby sleepy. Don't fight that.

These are my top tips for getting off to the right start. No need to prepare your nipples and breasts physically, but you can arm yourself with knowledge and support to be as ready as possible. So when your aunt insists that you begin rubbing your nipples with a wash cloth, just smile politely, let her believe what she wants, and know that your body is preparing you physically, and you are preparing yourself mentally and emotionally. Just say no to raw nipples while pregnant!