Let’s Talk: 4 Steps To A Successful Breastfeeding Conversation
Evi Dewhurst / June 2015
Imagine, for a moment, the experience of a new mother with a premature infant. Already dealing with the trauma and fear that comes with having a child in intensive care, she must now accept that she cannot hold and breastfeed her baby as she had planned. Instead, she is faced with using a breast pump accompanied by a user’s manual. She has never been introduced to a breast pump before and is not immediately comfortable with the idea, much the less the use of, such a device.
Krista Rogulie is such a mother. When her son was born at 28 weeks on September 19, 2014, he was not the healthy Christmas baby she was expecting. At only two pounds and thirteen inches, her son was incredibly tiny and so very fragile. He was immediately whisked away to the NICU. After her initial recovery, she was handed a generic brand breast pump with instructions to turn it to the highest setting for use. Unfortunately she had not received early education on the use of pumps, and lactation experts were not readily available during her hospital experience. Days later, successful milk initiation had not been achieved. Painful injuries caused by the improper pump setting challenged her ability to continue. She began to question whether she was capable of producing breast milk for her son at all.
As a clinical professional, what would you have done differently to improve Krista’s experience, not only to ease her pain and fear, but also to deliver ideal human milk nutrition to her son, who was struggling to survive in neonatal intensive care? Early familiarity and education would have helped her in the long run, which in turn would have impacted her level of confidence, and ultimately success. Perhaps a new outlook is needed. What if you could change the conversation right now… and the outcomes?
Introducing pregnant women to the benefits of a breast pump early in the conversation helps mitigate many issues. Some women feel too embarrassed to ask questions about something so personal, and perhaps foreign to their experience. Others expect breastfeeding will be a natural, easy activity, not realizing that breastfeeding challenges are many. Your early intervention can change all that.
Early intervention is also critical for new mothers struggling with breast milk initiation and volume building. One of the three most frequent reasons mothers stop trying to breastfeed in the first month relates to a perception of production: “I didn’t have enough milk.”3 Your anticipatory and open communication about breastfeeding and breastfeeding tools can mean the difference between a mother who gives up, or the mother who continues on.
Confidence is necessary for successful breastfeeding and pumping. As a knowledgeable professional, your information sharing and helpful encouragement can have a positive impact on a mom’s self-confidence and ability perceptions.
Related to perception and confidence, Kingston et al call out self-efficacy in their research, defining the context as “a woman’s perceived ability to successfully master a task such as breastfeeding.” Concluding their studies in regard to a woman’s ability to successfully breastfeed with any longevity, they feel that self-efficacy is directly related to an increased duration of breastfeeding. 1 By helping women become more comfortable with breastfeeding and breast pump use, clinicians can actually encourage women to feel more comfortable with breastfeeding overall and for a longer time. Or, if women find themselves in a situation where exclusive pumping is necessary, it will be one less hurdle to overcome, allowing them to move into the role of provider with less confusion and fear of failure.
In their recent updated position statement, AWHONN (Association of Women’s Health, Obstetric and Neonatal Nurses) maintained that “the benefits of ensuring exclusive human milk feeding through the use of breastfeeding supplies, when necessary, far outweigh any risks.” While acknowledging breastfeeding is best, leaders in women’s and infant health know that any effort to provide human milk to both preterm and full term infants is valuable indeed.
“All mothers should receive evidence-based education and support with which to make informed decisions regarding pumping milk and establishing and maintaining milk supply during their entire hospital stay.”2
– AWHONN Position Statement
A clear path to education is important for a woman during her initial plan to breastfeed and also as a breastfeeding mother. Given the physical changes her body will undergo during prenatal and postnatal periods, continuing resources will be valuable in encouraging a woman to be comfortable and confident with her decision. In addition to your own coaching, mothers would benefit from resources they can access 24 hours a day. Medela is proud to offer such supportive education to mothers through a variety of materials, and most recently with Breastfeeding University.
Breastfeeding University is a ten-course online program designed to prepare expectant and new mothers for the experience of breastfeeding. Each class is about ten to twelve minutes of education. Medela created Breastfeeding University out of a clearly defined need: Women were looking for additional resources to support their breastfeeding journey. Yet another goal was to empower women with the morale to be comfortable with honest conversations with their healthcare provider about any questions or difficulties they continued to face.
Immediately following the launch of Breastfeeding University, success was verified: Moms who participated in Breastfeeding University classes were surveyed after their experience. Over 97% said they felt more confident asking for breastfeeding help in the hospital as a result of participating in the courses. Learn more about our Breastfeeding University courses here.
The Right Technology
Breast pumps are tools to meet the needs of a mother, but also take into account the needs of an infant as well. Ensuring moms are using the correct pump with the right technology is important for breastfeeding success. Consider these three scenarios, and how each impacts the need for breast pump support:
Successful Initiation: Personal Use Pump as Needed
In this mother-infant relationship, the baby is healthy and able to breastfeed, while the mother is able to initiate breastfeeding with no significant issues. If mom needs to return to work, a personal-use pump will be valuable to encourage her to continue providing breast milk for her infant.
Initiation Help: Hospital Grade Pump and Personal Use Pump
In this situation, mom and/or baby experience obstacles to successful breastfeeding. Sometimes mom needs help initiating her milk supply, and this is the perfect opportunity to introduce a professional-grade breast pump, such as the Medela Symphony® Breast Pump. Medela’s 2-Phase Expression® technology has been shown to achieve faster milk ejection and faster milk flow.* Later, mom can introduce a personal-use pump into her routine in order to maintain her milk supply or to continue pumping breast milk when she must be apart from her baby.
Pump Dependent: Hospital Grade Pump and Personal Use Pump
Unfortunately, health issues or other circumstances sometimes prevent mother and baby from being able to breastfeed. It could be a situation where the infant is preterm and in the NICU or has health issues preventing the ability to breastfeed. A hospital-grade breast pump such as the Medela Symphony with Preemie+™ Initiation Technology can help mom initiate her breast milk supply. The Preemie+ pattern was specifically designed for initiation of lactation. Meier et al tested this pattern and found that the “pattern more effectively removed colostrum and helped mothers ‘come to volume’ quicker compared with a standard breast pump suction pattern.”4 After initiation is achieved, the Symphony Breast Pump can continue to help mom build and maintain her breast milk volume for the duration of her infant’s hospital stay. And upon taking her baby home from the hospital, a personal use pump can help a mother feel confident and capable in continued breastfeeding efforts.
Where To Go From Here
You may be wondering, “What happened to that mother? How did Krista and her baby fare in the end?” We’re happy to report that education and the right technology turned her situation around. She was able to readily supply her premature son with the best nutrition possible, thanks to Medela Symphony Preemie+ Initiation Technology. Today her son is home and doing well.
As a healthcare professional, you care deeply about your patients. You strive to help them achieve best possible health outcomes. In your unique role you have the ability to affect two patients at once: mothers and their infants. By employing early intervention, support to increase confidence, sharing education tools and using the best pump with the right technology for the situation, you can influence breastfeeding outcomes with even greater results. That’s a conversation worth having!
Click here to view a new infographic showing stages
of infant/mother breastfeeding readiness and the
Right Technology for Breastfeeding Success From Hospital to Home.
1. Kingston, Dennis , C. L. & Sword, 2007. Exploring breastfeeding self-efficacy. Journal of Perinatal & Neonatal Nursing, 21(3), 207-215. Doi: 10.1097/01.JPN. 0000285810. 13527. A7
2. Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) 2015 Position Statement
3. Li R, Fein SB, Chen J, Grummer-Strawn LM. Why mothers stop breastfeeding: mothers’ self-reported reasons for stopping during the first year. Pediatrics. 2008 Oct;122(Suppl 2):S69–S76.
4. Meier, PP, Engstrom, JL, Janes, JE, Jegier, BJ, Loera, F. Breast Pump Suction Patterns that Mimic the Human Infant during Breastfeeding: Greater Milk Output in Less Time Spent Pumping For Breast Pump-Dependent Mothers with Premature infants. Journal of Perinatology, Volume 31, Advance Online Publication 2011
5. Kent,J.C. et al. Volume and frequency of breastfeeds and fat content of breastmilk throughout the day. Pediatrics 117, e387-e395 (2006). / Kent,J.C. et al. Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Breastfeed Med 8, 401-407 (2013).
*When pumping at maximum comfort vacuum