Birth Plan - Breastfeeding

[Fantail]

I wondered if you could help me with what I should put in my birth plan regarding breastfeeding. After reading a number of threads on MN over the past few weeks I am very concerned, that because breastfeeding is not necessarily most women's automatic choice of feeding their baby I will not get the support that is needed to successfully establish feeding.

I should mention that I originally come from NZ, where there wasn't the move in the 1970s to bottle feeding, so most people my age (early 30s) were breastfeed and that trend continues today. I am one of the last of my friends to have a baby and I can't think of anyone who has FF out of choice over necessity. I am fully aware that breastfeeding isn't automatically successfully for everyone, but I am concerned that I will get told to offer a bottle of formula, rather than be supported to correct what ever is wrong.

The hospital that I am due to give birth at has only registered its intention to become baby friendly, rather than actually being accredited. So I am presuming that I may not be on the receiving end of good advice.

So what are the essential points that I should make?

I intend to breastfeed and no formula or water is to be given without medical indication and my permission.

Perhaps find out who is incharge of Infant feeding in your trust. This person should be very well versed breastfeeding and if you have a name, you can ask for that specific person to come and see you on the ward if you have any difficulties with the other staff c

State that you want the baby straight to your chest skin to skin. (assuming there is no medical emergency that means the baby is taken away). Personally I wouldn't worry about having the baby cleaned up first either.

Do you fancy a home birth? Not saying it makes bfing any easier but it does mean that mws are guests in your home and you don't have to fit in with the hpospital routines so much.

Let the hospital midwives know at your antenatal appointments and then when you go in the give birth. By all means out it on your birthplan too, but be warned that the birthplan usually goes out the window if anything slightly awry happens.

Probably the points you want to make are
1 - I would like skin to skin contact and to bf my baby immediately after birth.
2- Intend to continue to bf baby.
3 - Would like hospital to provide support.

It would be worth having the phone number of a bf counsellor/support too.

The NCT Breastfeeding helpline is open 8am-10pm and the number is 0300 330 0771. Put it in you phone now; I wish I had.

Is there a Baby Cafe near you?

There is also La Leche League, but I have no experience of them.

Ask for immediate skin-to-skin contact and that any newborn checks should wait a while if there is no cause for concern.

Ask to keep your baby with you at all times if possible.

And get your DP on side to help fight your corner if you're too knackered.

You can contact a BF support group to get info and support before your baby is born, see if there's a LLL group near you.

You won't necessarily be given rubbish advice at the hospital but it's best to prepare yourself so you have an idea of what to expect and take some phone numbers of BF counsellors with you in your hospital bag so that you can phone someone for help if you need to.

I'd suggest requesting to be allowed try to BF before you move from the delivery ward in your own time. I didn't specifically and in the haze of it all, only tried to feed DD after being moved around the hospital. Seems so obvious now but your brain will probably be fried.

Thank you for your responses so far.

Unfortunately I and my DH are not comfortable with a home birth, but I am hoping to use the brand new MLU at the local hospital (I am actually excited about this!).

I will get name of the key person at the hospital. I don't haven't had any appointments at the hospital, so don't know any midwives there yet.

So:

• Skin to skin
• No formula unless with my approval (or DH's)

If it is necessary to give formula, should I say that this is to be cup or syringe fed?

I already have the numbers for support lines etc, but it is a good idea to have them in my phone for the hospital.

i had a lot of help from the Infant Feeding Coordinator at my local hosp, definitely worth contacting her in advance if there is one at yours.

Keep asking for help. At the hospital I was at (also working towards unicef baby friendly status) the MWs often didn't like to push bfing help, but would help if asked. The level of help varied alot tho.

I had bits in my birth plan, but it wasn't really neccessary as they encouraged bfing and skin-to-skin whatever.

Agree with everything so far. Our local hospital is Baby Friendly but its very much a case of who shouts loudest gets the help.

Putting the numbers of the helplines in your phone is good advice and I would also reiterate getting the numbers of any local Bfing Counsellors too, getting the name of the Infant Feeding Co-ordinator and asking for skin-to-skin.

Both mine where cold when born and the hospital wanted to put them on heated pads to warm up, I prefered to stick them down my top. One of the MWs said that was much more effective and helped to establish bfing but nobody had suggested it to me.

Also, find out if there are any Baby Cafes, LLL, NCT and Bfing Support Groups in your area and go along before you have LO if possible. I know Mums who have only got support in hospital because the local NCT have caused a fuss on there behalf.

Re methods of feeding formula: I had a section and my milk took ages to come in so we latched on when DS was hungry to get BFing established but had to supplement with formula. The hospital automatically gave me a syringe and I put my pinky in his mouth, only squirting formula in when he sucked so he learned to associate sucking with tasty milk!

Best of luck- there's so much support out there so you should get by just fine. And stick to your guns!

Going by all the recent hoo haa about iron, you might also want to ask that they don't cut the cord before it has stopped pulsating? There is something about that maximising your BF baby's iron stores.

I had a birth plan which was followed religiously up to this point (I'd read it in the Ina May Gaskin book)......next time my DH would be more assertive about such things (he says!)

My friend's DH phoned the NCT whilst she was in hospital (and baby in SCBU) and sourced all the appropriate advice (wrote it down for her!)when he thought the hospital were not giving it. She BF until her son was 20 months!

http://www.kellymom.com/bf/start/index.html is a wonderful website. Worth reading through beforehand, perhaps printing off bits to take to hospital as a reminder, and referring back to as your breastfeeding relationship develops.

Other than that, I'd echo others and say be very clear, and to the point, in your birth plan.

I had a little separate heading in my birth plan that was called 'Breastfeeding' in bold just below 'Delivery' so it was very clear that once the baby arrived safely it was the most important thing on my mind :)

Mine said something like 'I intend to exclusively breastfeed my baby. Therefore I want immediate skin to skin contact (picking up my baby myself after delivery if possible) and wish to feed my baby as soon as possible after birth. I may require help from staff to achieve this.' I then said something like 'To assist breastfeeding, I wish for my baby to be handled mainly by me and her father unless specific medical attention is required'. I basically didn't want anyone to have the chance to take her from me as I wanted her on my chest the whole time in the immediate aftermath :) For DD, it further said something like 'As I intend to breastfeed, my baby should not be given formula without my express permission, each and every time it may be required. If one formula feed is required, this does not mean I have given my approval for further formula feeds.' This was because post DS when we were both a bit the worse for wear I gave permission for one formula feed when he hadn't fed for 16 hours, and they then later gave him another without getting further permission when I was asleep!!!

Get your DH on side too. He may need to be your and your baby's advocate because even if everything goes well you may just be too knackered to get the help and support you need.

Best of luck :) Just to reassure you, I had a rotten experience of bf support in hospital first time round but still managed to feed DS for a year, and with DD at a different hospital, just starting on the road to Baby Friendly Status, I had a wonderful experience with huge amounts of respect for my wishes and help to get breastfeeding established. Still ebf at 19 weeks :)

Good point about the cord theidsalright .

Fantail- You may also like to have a read of this . Not all of it will be relevant as it's from the Australian Breastfeeding Association's website but it gives some good ideas.