ASK AN EXPERT: Preparing to Breastfeed

Lesly’s Note: A major part of my parenting journey included breastfeeding. I nursed Mia for three years and I’m currently a peer leader with San Francisco La Leche League! I talk about nursing all the time with my friends and I’m excited to share some expert advice from IBCLC breastfeeding consultant Farrell Topham on how to prepare for breastfeeding success before your baby arrives.

Farrell Topham, IBCLC is an International Board Certified Lactation consultant in private practice and parent educator. Farrell offers breastfeeding consultation and support in the comfort of your own home and teaches prenatal classes through Kaiser Permanente, St. Luke’s hospital, and Community Well. As a native San Franciscan, Farrell is dedicated to growing healthy, joyful families throughout the Bay Area. Connect with Farrell on FacebookInstagram and her website,

By Farrell Topham, IBCLC

Farrell Topham, IBCLC and breastfeeding coach extraordinaire!

Farrell Topham, IBCLC and breastfeeding coach extraordinaire!

During pregnancy moms-to-be are encouraged to breastfeed because it is “natural.” Because of this, many moms assume that once their baby is born breastfeeding will just magically happen on its own. While it is true that breastfeeding is the normal way to feed human babies, it is absolutely a learned skill and may not immediately come naturally to mom.  Not only must each family learn to breastfeed, but they must learn to do it after having just done the incredible hard work that is labor and birth. As a result, it is essential to start preparing to breastfeed before baby is born.

Prenatal Education
Breastfeeding is a dance involving the hormones of mom’s body, baby’s reflexes and both parties’ active participation. One of the most common reasons moms quit breastfeeding is low milk supply and perceived low milk supply. Few mothers understand that milk supply is something that must be carefully grown and established in the first few days postpartum. I advise every family to take a prenatal breastfeeding preparation class so that they can learn how to build mom’s milk supply and set themselves up for success. Prenatal classes are great for learning about normal newborn behavior and many parents report having a much more pleasant transition to parenthood in the early postpartum period if they attended prenatal breastfeeding and newborn care classes. Most birthing hospitals offer prenatal classes —in San Francisco I also recommend checking out Community Well, Natural Resources, Carmel Blue and DayOne Baby for small group prenatal classes.

Partner Support
Don’t forget to bring your partner to class! Your partner is the most important person in the recipe for breastfeeding success; if they are going to support you they need to learn the ins and outs of breastfeeding and lactation too. Have a prenatal discussion with your partner about how they can help with breastfeeding so that they are prepared to jump in when the time comes. Wondering how partners can help mom and baby with feeding if they don’t have lactating breasts?! Some of my best tips for partners supporting a breastfeeding mom include:

Eyeball her! Moms tend to get into funky positions during breastfeeding. Take a look and see if you can offer her a footstool or a shoulder massage to relax her upper body and neck.
Feed mom to feed baby! Breastfeeding moms need about 500 extra calories per day and may also be thirsty. Get ready to offer mom water and nutrient dense snacks during feeding (and yes you may have to pop them right into her mouth when her hands are full :)
Get your massage on! One of the best ways to help build and improve your baby’s feeding skills and digestion is to massage him or her. I highly recommend families take an infant massage class after baby is born, but any strokes you can make up at home are helpful as well. Massaging your baby’s face and head in particular will encourage optimal breastfeeding.

Have the Right Supplies
My favorite mantra for new parents is “less is more.” You really don’t need tons of gear to be an excellent parent to your baby, and the same is true for breastfeeding. A few things I do recommend purchasing are:

My Brest Friend—This is my favorite nursing pillow for newborns. To prevent discomfort with breastfeeding, a good pillow helps raise baby up to the level of your breast. This one was invented by a San Francisco dad!
Nipple CreamMotherLove or Earth Mama Angel Baby are two options for all natural nipple creams. Pain is not normal with breastfeeding. However, remember that breastfeeding is a learned skill. It’s not uncommon to have issues in the very early days, and nipple cream can help.
Moby Wrap—One of the best things you can do to help establish breastfeeding is keep your baby skin to skin. This creates a connection between mom and baby and encourages baby’s feeding reflexes. A soft stretchy baby carrier like the Moby, Boba, or Solly wrap is a great way to keep baby skin to skin while allowing mom or partner to be hands free. And as a bonus, research shows that infants who are worn for a minimum of three hours per day cry about 40% less. That’s amazing!

Mia and I took part in a breastfeeding photo exhibition called the Urban Lactation Project. Photo by Jazmin Morelos

Mia and I took part in a breastfeeding photo exhibition called the Urban Lactation Project. Photo by Jazmin Morelos

Establish Your Support Network
Taking care of a newborn is a life-altering experience. It is essential to build your support network—other parents and professionals—in the early days so you have quick access to help and support when you need it after baby is born. I strongly suggest that every parent try to attend weekly or at least monthly support groups during the first few months of baby’s life. It is invaluable to talk to other parents who are experiencing similar things to you at that moment. From a mental health perspective, it’s very beneficial to have a weekly destination (“on Wednesday I go to breastfeeding group”) to get out of the house and keep up morale. In SF we have several excellent options for parent support—mom groups, partner groups, breastfeeding groups and more! 

Once you have a “parent tribe,” add professional help if you have more serious breastfeeding issues once baby is born. The gold standard for professional lactation guidance is the International Board Certified Lactation Consultant or IBCLC. If your breastfeeding issue is acute and time sensitive such as pain, concerns about your baby’s weight or your milk supply, you can see an IBCLC where you gave birth, or hire one for a home visit. Before baby is born, check out your hospital’s resources for outpatient breastfeeding support and have the name of a private practice IBCLC who could make a home visit in your area (another great job for partners!).