Booby Traps Series: Does your OB follow Academy of Breastfeeding Medicine protocols?

This is the sixth in a series of posts on Booby Traps™ during pregnancy, made possible by the generous support of Motherlove Herbal Company.

I have a dentist appointment later this week.  And while I can’t say I’m looking forward to it, I’m not at all concerned that my dentist will say anything that would conflict with what any other dentist might say.  Myth, tradition, and personal experience don’t seem to play much into his recommendations about how I floss.

But unfortunately in the world of breastfeeding, this is often not so.  The most common thing I’ve heard moms say about the care they get is “everyone I talked to said something different.”  One family said to me in puzzled exasperation, “we just do whatever the last person we talked to says to do.”

Enter the Academy of Breastfeeding Medicine.  They are an organization of physicians, kind of like the American Academy of Pediatrics, but for breastfeeding.  Their members include some wonderful doctors, including Alison Steube (who wrote last week’s post), and Jenny Thomas, who wrote my all time favorite post on the role of pediatricians in breastfeeding care.

The Academy of Breastfeeding Medicine has also developed some evidence-based policy recommendations (“protocols“) on a variety of topics important to our breastfeeding success.  They are available in a variety of languages and are suitable for printing out and handing to your physician, or the hospital, if they are not giving you accurate advice.  You can even save a link on your phone for ready access in the hospital.   What’s great is that they are written by physicians for physicians, so your doctor may be less likely to dismiss them.

One of their protocols addresses the topic I’ve been writing about so far in this series:  breastfeeding care during pregnancy.  Here’s what they say about the care you should be getting from your OB or midwife during your pregnancy when it comes to preparation and support for breastfeeding:

  1. Your OB/midwife’s office should be breastfeeding-friendly.  That means that the staff in the office is trained to promote, protect, and support breastfeeding, and that the office should has a written breastfeeding policy.  You should see no formula literature or samples anywhere in the office, and your intentions concerning feeding should be recorded in your medical record and transferred to the hospital and any other provider.
  2. Your OB/midwife should be promoting and teaching about breastfeeding throughout your prenatal visits.  Early in pregnancy you should hear a statement like, “As your doctor, I want you to know that I support breastfeeding.  It is important for mothers and babies.”
  3. Your OB/midwife should gather and record information about your feeding history, including any breastfeeding difficulties you’ve had in the past.  He or she should also determine if any of you family medical history makes it particularly important that you breastfeed, such as diabetes, asthma, eczema, and obesity.
  4. Your OB/midwife should consider your family dynamics, cultural background, and community, enlisting the help of key family members if appropriate.   She or he should be able to respect cultural traditions and taboos associated with breastfeeding while sensitively educating about traditions that might get in the way of breastfeeding.  And he or she should be aware of his or her own cultural attitudes when interacting with you.
  5. Your OB/midwife should incorporate breastfeeding into your prenatal breast exam, looking for things like inverted or retracted nipples, explaining what to expect in terms of breast changes during pregnancy, and referring to lactation consultants if there is cause for any concern.
  6. Your OB/midwife should talk about breastfeeding at each prenatal visit, encouraging open dialogue, affirming your feelings, and providing targeted education.  Each trimester your OB/midwife should discuss different topics, from a fairly open ended discussion during the first trimester, to education in the second trimester, to preparation for birth and the newborn period in the third trimester.
  7. Your OB/midwife should empower you to have a birth experience most conducive to breastfeeding.

A tall order, right?  It might seem so, but good OBs and midwives can integrate all this fairly seamlessly into our prenatal visits.  And when they do the research is clear:  moms will have a far better chance of achieving their breastfeeding goals.

Did any of you experience prenatal care from your OB or midwife that met these standards?  Please share!

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13 Comments | Last revised on 03/23/2011

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