Prenatal education

What should I know before giving birth?

Most mothers-to-be have questions about how to feed and care for their babies. Mothers may have concerns about finances and the cost of the new baby or may be in difficult situations. Health-care providers can provide care and information about resources. Friends who have breastfed can support new mothers and breastfeeding education can increase breastfeeding success. 

A) Learning about breastfeeding when pregnant

Most first-time mothers have not seen many other mothers breastfeed. Mothers who have questions about how to breastfeed can consider:

Mothers who receive breastfeeding education and support are more likely to start breastfeeding and breastfeed exclusively (Cohen 2018; Huda 2021).

B) Helpful information for pregnant mothers

Here is a list of topics families may find helpful during pregnancy and for the first few days after delivery:

1) Reasons for considering breastfeeding

  1. How will breastfeeding help me?
  2. How will breastfeeding help my baby?
  3. Will breastfeeding protect my baby from infection and death?
  4. Will breastfeeding prevent my baby from developing chronic diseases?
  5. Will breastfeeding help my baby's brain develop?
  6. How does breastfeeding affect my baby's gut bacteria?
  7. What is food security?
  8. How will breastfeeding help my family?
  9. Do I want to breastfeed?

2) Preparing to breastfeed

  1. What are the official breastfeeding recommendations?
  2. Does my baby need vitamin D?
  3. Which vitamin D preparation should I use?
  4. What happens in the first three months of pregnancy?
  5. What happens in the second three months of pregnancy?
  6. What happens in the last three months of pregnancy?
  7. Are my breasts normal?
  8. Why is the nipple root important to breastfeeding?
  9. How do I get my nipples ready?
  10. Should I worry about the quality of my milk?
  11. Someone told me colostrum is dirty. Is that true?

3) Equipment

  1. What should I know about breastfeeding pillows?
  2. Should I use a breastfeeding bra?
  3. Do I need breast pads for leaking?
  4. What supplies should I take to the hospital when I’m about to give birth?

4) Understanding your baby

  1. How do I know when my baby is hungry?
  2. What should I know about a baby's crying?
  3. How do I know if my baby is getting enough milk?

5) Being with your baby

  1. What is skin-to-skin care?
  2. What is the breast crawl?
  3. How long should my baby sleep at night?
  4. Do I need a pacifier to calm my baby?

6) Breastfeeding the newborn 

  1. How do I position the baby at the breast?
  2. Which breast do I start on?
  3. How do I latch my baby?
  4. What's the sandwich technique for latching?
  5. How does my baby act while breastfeeding?
  6. How long do breastfeeds last?
  7. How do I know when the baby is finished feeding?
  8. How do I take the baby off of my breast?
  9. Should I use one breast or two?
  10. How often do babies breastfeed?

7) Newborn behaviour

  1. How do I prepare for the first breastfeed?
  2. What should I expect when my baby is a few hours old?
  3. What should I expect when my baby is two days old?
  4. What should I expect when my baby is four days old?

8) Breastfeeding challenges

  1. How does a Caesarian section birth affect breastfeeding?
  2. What are the signs of a newborn baby not getting enough milk?
  3. Is my baby's slow growth caused by a low milk supply?
  4. Can you tell me about breastfeeding a premature baby?
  5. Is it normal to have nipple pain with the first feeding?
  6. What is breast engorgement?
  7. Can I take medication and still breastfeed?

9) Supplementing with extra milk

  1. Can you tell me about giving my baby extra milk?
  2. What is expressing and when is it effective?
  3. What are milk banks and pasteurized donor human milk?
  4. What should I know about infant formula?
  5. Should I use liquid or powdered infant formula?
  6. How much does infant formula cost?
  7. How do I prepare infant formula?

10) Supports

  1. Where can I find support?
  2. What should I look for in a health-care provider?
  3. Where can I get specialized help with breastfeeding?
  4. Where can I get more breastfeeding information online?
  5. What should I look for in a hospital?

C) The cost of a new baby

Having a baby can be expensive. It can limit the amount of money available for the family’s other needs and cause stress. Unfortunately, childbirth and child rearing have been heavily commercialized leading to additional or unnecessary items and expenses (Taylor 2020). This can also increase waste.

1) Breastfeeding

Breastfeeding is much more cost effective than infant formula. If using infant formula, consider that different products can have very different pricing and there may be ways to decrease the cost. Please speak with your health-care provider if you have any further questions.

2) Reduce: only buy what you will need

Talking to other mothers or using on-line resources may help mothers decide on which items are needed and which are not. Consider only making purchases when they are clearly needed instead of stock-piling them.

When buying items, avoid single use products such as disposable breast pads. Reusable items will help to reduce the long-term cost.

Disposable diapers are expensive and a baby may use as many as eight in one day. Consider using reusable cloth diapers. Flat sheet diapers need to be folded but are generally cheaper to buy than pre-folded ones. They are also cheaper in the long run because they dry more quickly and can accommodate a growing child. Cloth diapers can also be more environmentally friendly and expose the baby to fewer chemicals.

Baby bum wipes can be replaced with soft facecloths. Mothers may wish to buy ones that are a different colour from those used by the rest of the household! Compared to baby wipes, cotton facecloths are cheaper, feel nicer for the baby when rinsed with a small amount of warm water, have environmental benefits, and may be safer for the baby.

3) Reuse: consider gently-used items

Family members may be able to pass along maternity clothing, breastfeeding bras, baby clothing, and other items. These can also be found at consignment stores and second-hand stores.

Ensure that any used items such as cribs and car seats are safe before using them. Items may not meet current standards or be broken.

4) Recycle: help someone else

If you are no longer using certain items, consider selling them or passing them along to another mother.

5) Laundry

Laundry can significantly add to the cost of a baby’s care and can be bad for the environment. These can be minimized by:

  • Using larger loads.
  • Keeping washing temperatures below 60°C (140°C).
  • Using energy efficient appliances.
  • Tumble drying as little as possible and line dry instead.

D) Mothers at risk

Some mothers are in difficult situations including illness, mental health challenges, or difficult social situations. All of these can be barriers to breastfeeding and affect their overall ability to parent.

During pregnancy and after giving birth, mother's brains adapt to parenting. Brain cells are created, various parts of the brain grow, and the brain circuits change (Kim 2010; Leuner 2016).

These changes support parenting as they help mothers understand their babies’ social cues and respond appropriately, feel positive when reacting to their baby’s cues, and cope with the stresses and demands of parenting (Kim 2016). These changes in brain structure have been shown to last at least two years after giving birth (Hoekzema 2017). Mood disorders, severe stress, and trauma may disrupt these changes (Kim 2016). Mothers in such situations benefit from additional help and support.

References

Cohen SS, Alexander DD, Krebs NF, et al. Factors Associated with Breastfeeding Initiation and Continuation: A Meta-Analysis. J Pediatr. 2018 Oct 4. pii: S0022-3476(18)31118-1
 
Hoekzema E, Barba-Müller E, Pozzobon C, et al. Pregnancy leads to long-lasting changes in human brain structure. Nat Neurosci. 2017 Feb;20(2):287-296

Huda MH, Chipojola R, Lin YM, et al. The Influence of Breastfeeding Educational Interventions on Breast Engorgement and Exclusive Breastfeeding: A Systematic Review and Meta-Analysis. J Hum Lact. 2021 Jul 6:8903344211029279

Kim P. Human Maternal Brain Plasticity: Adaptation to Parenting. New Dir Child Adolesc Dev. 2016;2016(153):47–58
 
Kim P, Leckman JF, Mayes LC, et al. The plasticity of human maternal brain: longitudinal changes in brain anatomy during the early postpartum period. Behav Neurosci. 2010;124(5):695–700
 
Leuner B, Sabihi S. The birth of new neurons in the maternal brain: Hormonal regulation and functional implications. Front Neuroendocrinol. 2016;41:99–113
 
Rosen-Carole C, Hartman S; Academy of Breastfeeding Medicine. ABM Clinical Protocol #19: Breastfeeding Promotion in the Prenatal Setting, Revision 2015. Breastfeed Med. 2015 Dec;10(10):451-7

Taylor AM, Alexander J, van Teijlingen E, et al. Commercialisation and commodification of breastfeeding: video diaries by first-time mothers. Int Breastfeed J. 2020;15(1):33