Parents rely on care providers to guide and support them in keeping their babies healthy. Breastfeeding is impactful in this process. Like many parents, you may struggle with making decisions about caring for your baby. Knowing that the professionals you are turning to can be trusted to support breastfeeding is such a relief.
While being supportive of breastfeeding is helpful from all care providers, there are some providers where it is pivotal. These are birth care providers (Obstetricians, Midwives, etc.) and primary care providers (Pediatricians and Family Medicine Providers during the breastfeeding period). Here are some tools to help in choosing a provider, as well as ideas for communicating with already chosen providers. You also can check our list to find an array of healthcare providers who have affirmed their commitment to breastfeeding family friendly healthcare in our community.
A Breastfeeding Friendly Environment
During visits to/with your provider (or potential provider), you can start by noticing the environment they provide.
- What images surround you in their office?
- Is breastfeeding normalized through pictures of nursing families or are there more bottle feeding/pacifier-based images?
- Are there ads for formula?
- Are there materials or objects with the brands of formula companies? (Nestlé, Gerber, etc.)
- Advertising formula or formula feeding products is not considered breastfeeding friendly, even though breastfeeding friendly providers may also support formula feeding families or families giving both breastmilk and formula.
- Research shows that advertising formula is subtly discouraging of breastfeeding
- Are formula samples visible in the waiting room or exam rooms?
- It’s not against the rules to have formula or bottles available for a baby in need, but it’s not considered breastfeeding friendly to have formula or bottles out as samples.
- Do they have educational materials out?
- If so, does this include breastfeeding information and resources for support or education?
Since we are fortunate to be resource-rich in options for support, education, and clinical lactation care, information about breastfeeding support groups, classes, and lactation consultants are available in many offices. Check to see what information the office has out. There are actually very defined guidelines for what marketing materials that a breastfeeding baby friendly office will have out for parents. The most breastfeeding friendly practices will follow these rules.
Birth Care Providers
Pregnancy is the best time to begin your search for a breastfeeding-friendly doctor or clinic. Support is important; research shows that breastfeeding support in prenatal, birth, and postnatal care will help you meet your breast/chestfeeding goals.
Different practices while giving birth -and immediately after birth- can make a big difference in how smoothly things go with establishing breastfeeding. You may be choosing a provider or wondering if your current provider is breastfeeding friendly. Some of the most common things that can really affect breastfeeding are:
- IV fluids during and after labor
- Induction
- Cesarean Birth
- Oral invasion, like suctioning
- Skin to Skin contact
- Separation of parent and baby
- Bathing in the first 24-48 hours
- Protocols for supplementing
Here are some articles that summarize many of these things, too.
9 Birth Interventions That Can Affect Breastfeeding
The links in the list above can provide information about how birth care providers affect breastfeeding. Choosing a provider who knows and appreciates this can make a big difference! In Orange County families can choose from a variety of options, including Obstetricians, Midwives, and Family Medicine Physicians. Most practices have more than one provider in them and some may be more invested in supporting breastfeeding than others. Some things that you might experience with a breastfeeding supportive provider might be:
- They bring up your feeding plans with you and seem comfortable talking about breastfeeding. They specifically discuss breastfeeding preparation.
- They encourage you to attend breastfeeding support groups and classes during pregnancy and afterward.
- They provide information to you about local options for breastfeeding support and information.
- They do not give formula samples to parents expressing plans to breastfeed
It is a good sign if you feel safe talking to your birth care provider about breastfeeding. It is important that they know your plans for feeding your baby. Whether it is when they bring it up or if you choose to bring it up, here are some questions that it can be informative to ask.
- What are 3 ways that you support breastfeeding with your patients?
- What are the breastfeeding rates in your practice?
- A follow-up question would be what they think might improve said rates.
- How long do your breastfeeding patients usually nurse their babies?
- Of those that breastfeed, how many end up supplementing?
- How soon is supplementing usually started?
- Can you share with me what we can do, with birth, to help breastfeeding go smoothly?
- The list above will help with knowing what some good answers might be.
- What happens if things aren’t going well?
- What lactation consultants do you recommend if I want to consult prenatally?
- They should have some answers for you that includes a person’s name or a clinic’s info
- What local support groups would you suggest for me to attend?
- They should know of some off the top of their head
In many cases there is not one right answer. The answers should, however, give a solid sense of a provider who is paying attention to breastfeeding in their practice and attuned to the needs of parents who have that as a goal. It’s always wise to trust your instincts during these conversations.
Take a screen shot of these questions or download this pdf to have with you for this conversation
Primary Baby Care Providers
Many factors go into choosing and trusting a Pediatrician or Family Medicine Doctor to be your baby’s primary care provider. Breastfeeding can help in countless ways to help your baby thrive. It’s not always easy, at first, though. When there are hiccups in the early days, your baby’s primary care provider can make a really big difference. There are often multiple approaches to addressing feeding challenges. A provider who protects long term feeding goals can be a total game changer. It’s been shown that a pediatrician can play a pivotal role in breastfeeding success.
The office environment is a great place to start, in getting a sense of how breastfeeding friendly a provider is. After that, when choosing a provider, some great questions to ask are…
- What are 3 ways that you support breastfeeding with your patients?
- What training in breastfeeding have you had, since medical school?
- What are the breastfeeding rates in your practice?
- A follow-up question would be what they think might improve said rates.
- How long do your breastfeeding patients usually nurse?
- What growth charts do you use?
- Of those that breastfeed, how many end up supplementing?
- How soon is supplementing usually started?
- How often do they stop supplementing after starting?
- What happens if things are not going well with breastfeeding?
- Will you go by a 24 hour weight if I have a lot of IV fluids with labor?
- What if my baby loses too much weight?
- What if my baby has jaundice?
- What if my baby does not gain weight as expected?
- What if my baby is really fussy?
- In what situations do you discourage someone from breastfeeding?
- The decision to breastfeed (or not) is a personal one. There are very few medical reasons not to, if you want to breastfeed.
- If a person who wants to breastfeed thinks they need to quit, talking to a breastfeeding expert is always recommended.
- What lactation consultants do you recommend?
- They should have information on hand.
- What local support groups would you suggest for me to attend?
- They should know of some off the top of their head
Take a screen shot of these questions or download this pdf to have with you for this conversation
Many practices have multiple providers in them. Asking each provider these things, individually, is also wise. It is common that some providers, even in the same practice, are more invested in breastfeeding support than others. Each time you encounter a new provider, ask these questions again. You may find that you want to schedule intentionally with some providers over others.
For a provider you already have -especially if you do not have much choice of providers due to insurance or location- you can also ask questions during appointments when feeding is involved.
For example, if supplementing with formula comes up:
- What are the risks and benefits? (of supplementing, of not supplementing, of using formula or expressed milk…)
- What are the alternatives?
- How can I use my own milk?
- How can I protect my milk supply?
- What quantities are appropriate for my breastfed baby?
- How do I protect breastfeeding while supplementing?
- Can you help me with alternatives to bottles?
- Will you teach me to paced feed to avoid bottle preference?
- What is the plan for how to eventually stop supplementing?
- Can I try working with a lactation consultant first?
Here are more articles on breastfeeding friendly pediatricians
Is Your Pediatrician Actually Breastfeeding Friendly? (5 Ways You Can Tell)
Is Your Pediatrician Breastfeeding Friendly? 14 Questions to Ask.
Finding a Breastfeeding Friendly Provider
You should always trust your instincts about whether a provider is a good fit. When your choices are limited, you may find it helpful to ask questions as a way of advocating for and reminding a provider about your goals. The Academy of Breastfeeding Medicine also offers protocols for providers to follow that are evidence based and up-to-date. These can be shared with any provider. The good news is that, in Orange County, most people have options to choose from, to find someone who is a good fit and breastfeeding friendly.
Communicating with Providers
It can be easy to be distracted, overwhelmed, or intimidated while in an appointment. Here are some ideas that people find helpful.
You can schedule an appointment ahead of time (like during pregnancy) to discuss compatibility with a primary care provider.
- Checklists can help you to remember many of the details and offer questions to ask during your visit. Examples are in the PDFs linked below.
- Very few decisions have to be made on the spot. You can always ask for some time to think, in an appointment. A respectful provider will step away to give you this time during any non-emergency.
- Asking friends and family for a recommendation can be helpful, and also asking what it is, about that provider, that they really value is much more informative. Different people value different things in their providers.
- Having a “Breastfeeding Plan” -a list of preferences and desires- similar to a “Birth Plan” is a quick way to communicate desires. This is often especially helpful during a hospital stay where many providers (nurses, doctors, etc) over many shifts may be supporting you. This can also be shared with providers in prenatal appointments, to encourage conversations like above. There is also an example of this in a linked PDF below.
- You can also check our list to find healthcare providers who have affirmed their commitment to breastfeeding family friendly healthcare in our community.
