As long as I have been giving birthing courses (over 45 years) I have included a complete session on preparing for breastfeeding.  I see a tremendous difference when I do home visits postnatally between mothers who have attended programmes including breastfeeding preparation and those who went to public sector classes where breastfeeding is only mentioned in passing.

First of all we discuss expectations, advantages of breastfeeding, problems that they have heard from their friends etc.  I use slides or posters or film clips to explain the structure of the breast and the changes that occur during pregnancy and in the first days and weeks after the birth.  This is also an opportunity to discuss womens health issues without being scary.  What are normal lumps and changes associated with breastfeeding and when to take note if problems persist.
Stressing the importance of early breastfeeding can only be done pre-natally because by the time I see the client after the birth it is too late to discuss the sucking instinct of the newborn, the association between the fragrance of the nipple and the amniotic fluid from whence the infant has just emerged etc. etc.
In fact if I can, I try to get to the hospital immediately after the birth if the client has had a Cesarean birth as often there are well-meaning but misguided suggestions from staff to “rest and wait a day or two”.

Usually, clients seeking preparation for breastfeeding prenatally are already sold on the idea.  But if one is giving this in the context of the birthing class, there may be ambivalent, even hostile reactions.  In this case, take it easy, assure the client that they are not signing a life contract to breastfeed.  Give it a try so that the baby gets the valuable colostrum at least: my mantra is that a few days is better than none; a month is better than a week, three months ......etc. etc.  By taking it easy and not trying to brainwash recalcitrant clients they often will give it a try.  One of my clients had claimed that she wanted to miss the breastfeeding class as she only wanted to prepare for the birth. She had no intention whatsoever to breastfeed.  I told her that we would be discussing other postpartum issues too so persuaded her to attend.  A year later she called to tell me she was happily breastfeeding, had not experienced one single problem all the way, in fact had regularly called to tell me she had no problems!!

Of course if a client has experienced a previous trauma, sexual assault or has a hubby who thinks the breast is his alone, one needs different tactics.
So go with it, it is so rewarding.
Wendy Blumfield
NCT.UK Prenatal Tutor/Breastfeeding Counsellor
Former President, Israel Childbirth Education Centre
Haifa, Israel.

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