Prenatal visits

At your prenatal visits, talk to your doctor about your plans to breast-feed. Make sure he or she is knowledgeable and is able to guide you through the planning and initiation process. Ask for recommendations on books, classes, or support groups. You may also be referred to a lactation consultant.

A breast exam is a routine part of all first prenatal visits. Breast lumps and cysts will be evaluated to give your doctor a baseline from which to monitor any future changes in your breasts. Your nipples will also be examined. This helps your doctor to identify physical traits, such as inverted nipples, that may require special preparation for breast-feeding.

Talk to your doctor about how to handle any chronic health condition you have and how it might affect breast-feeding. Also ask about any medicines you take (both prescription and nonprescription) and whether they are safe to continue during pregnancy and breast-feeding.

Prenatal visits are a good time to talk to your doctor about where to have your baby. Check the breast-feeding policies of the hospital and birthing centers you are considering. It is much easier to breast-feed when you are in a supportive environment, such as a facility that has a lactation consultant on staff, encourages keeping the baby in the room with you (rooming in), and has a policy of not supplementing your baby's diet, even within the first 3 to 4 hours after a cesarean delivery, unless medically necessary.

After your baby is born

The doctors at the hospital or birthing center will help you to initiate breast-feeding, ideally within the first hour of your baby's life. Often a lactation consultant is available to help you throughout your stay and can be contacted after you return home. Lactation consultants are an important resource to reassure you and help you promptly address any problems.

Your baby should have a well-baby checkup before 1 or 2 weeks of age. The following will be assessed:

• Growth, including weight, length, and head size
• Activity level
• Breast-feeding patterns and whether you are having any problems

Call your doctor anytime you feel you need breast-feeding support. If possible, make an in-person visit with your baby or have someone knowledgeable about breast-feeding come to your home.

You will also have a postpartum exam scheduled approximately 6 to 8 weeks after giving birth. Although most breast-feeding issues are resolved by this time, this appointment offers you another opportunity to talk about any related problems or concerns. It is also a time to discuss birth control while breast-feeding.