Suggestions for successful breast feeding from nurse midwifery program

Most new moms know the benefits of breast feeding. For babies, it can lower the risk of developing asthma, diabetes, and leukemia. For moms, it reduces the risk of breast cancer. But many women still don't know where to turn for help when breast feeding doesn't go as smoothly as they imagined it would.

Laura Zeidenstein, CNM, DNP, director of the nurse midwifery program at Columbia University School of Nursing, offers three suggestions for successful breast feeding:

1. Plan ahead

Breast feeding is always challenging in the beginning, especially for a first-time mom. But those initial difficulties are easy to remedy with the right encouragement and face-to-face support, Zeidenstein says.

To get off to the best start, let the nurses in labor and delivery know you want to breast feed as soon as possible after delivery and request that your baby not receive any bottles. Also ask for the baby to remain in your hospital room if you want to nurse on demand. And if breast feeding doesn't work at first, don't despair.

"For the first hour after birth and the first six weeks after delivery, it's important for women to have the right encouragement and hands-on assistance on a regular basis," Zeidenstein says. "When you ask women what made them stop breast feeding, they will usually blame themselves and say they didn't make enough milk or that the baby didn't want it. But what really happened is they didn't get enough support."

2. Know your rights

The Affordable Care Act requires insurance to cover breast feeding services and support, including breast pumps and visits with a lactation consultant. The law also requires employers with at least 50 workers to give nursing mothers breaks to pump milk, and a place to do this other than a bathroom, for the first year after birth. New York is among the states that provide additional protections - here the breaks may continue for as long as three years.

"The Affordable Care Act encourages employers to give women a place to pump," Zeidenstein says. "New moms, especially if they have to go back to work in three months, still need support to learn how to pump in the right way and how to keep up breast feeding when they're away from the baby so many hours each day."

3. Find support

Breast feeding is a social and cultural occurrence, Zeidenstein says, and new moms are much more successful when they're around other women who are also nursing new babies. She leads a weekly breast feeding support group. Many hospitals also offer support groups, as do some pediatrics and women's health practices. The New York Lactation Consultant Association keeps a list of support groups in the metropolitan area.

"A support group gives women a mentor to guide them and reassure them that their experience is valuable, and also gives peer support," Zeidenstein says. "These groups are about helping new moms to trust their ability and learn that with just minor corrections and encouragement they can succeed."

Laura Zeidenstein has provided midwifery care in a variety of urban settings, both in hospitals and in freestanding birth centers including Roosevelt Hospital, Woodhull Hospital, SUNY Downstate Medical Center, the Maternity Center Association, and Elizabeth Seton Childbearing Center. She is currently a midwife at Midwifery of Manhattan. She received her graduate midwifery degree from Yale University in 1988 and her Doctor in Nursing Practice from Columbia Nursing in 2005.

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