Preparing for Breast Feeding During Pregnancy

What You Need

Breast Pump

• Different models come with different bells and whistles, but from a medical standpoint, the pump you buy should meet the following criteria:
  • Double-sided (pumps both breasts at the same time)
  • Electric/battery operated, rather than manual
    • Manual pumps don't stimulate your body as effectively.
  • Closed system, rather than open system
    • A closed system pump has a barrier between the milk collection kit and the pump mechanism to prevent contamination by bacteria/mold/viruses/etc.
• Once you have your pump on hand, you can use this helpful video to choose the pump flange (opening) size that’s right for your breast. This video is not meant to help you decide which pump to buy.

Haakaa Milk Catcher

• The Haakaa device is marketed as a manual pump, but in reality this product is helpful for catching milk that leaks from the other breast while you’re feeding your baby on one side. Every drop matters!

Pumping Bras

• These specialized bras hold your pump in place on your body to allow hands-free pumping.
  • Simple Wishes - cheap, effective, well-reviewed

Nursing Bras

• Maintain comfort during fluctuations in breast size, and provide easy access for baby.
  • Hotmilk - wirefree option, consistently reviewed positively for comfort
  • Kindred - simple, cheap, well-reviewed
  • Cake Maternity - more expensive, highest reviews for comfort, durability

Nipple Ointment

• Lanolin-based nipple ointment can go a long way in preventing nipple symptoms and treating them if they occur.

Nursing Pillow

• Provides support and positioning for baby during feeding. Especially helpful for first-time Moms and Moms who had c-section deliveries.
  • My Breast Friend

Formula

• Formula is a safe and effective short-term bridge to keep your baby satisfied until your voluminous, mature milk comes in around day 3, 4, or 5 of the baby’s life (see below).
• Most parents receive formula samples during pregnancy. Hold on to these so you don’t need to buy more.
• All formula is the same from a medical standpoint. Please ignore the clever marketing gimmicks.
• You can mix and match the samples you receive, and your baby will not care in the least.

Prenatal Vitamins

• We recommend Moms continue taking the same daily prenatal vitamin used during pregnancy for as long as they are breastfeeding.

Vitamin D Drops

• Vitamin D is important for bone growth and development.
• Breast milk is perfect in almost every way, except the fact it does not transmit vitamin D very well. For this reason, we recommend baby receive a daily vitamin D supplement. 
• The easiest option is one where the dose is 1 drop per day.
  • This can be given while baby is sleeping.
    • Simply wash your hands, place the drop on your finger, open the mouth by pulling down the chin with your opposite hand, and place your finger against the roof of the mouth.
  • Carlson Brand
• Avoid options where the dose is 1 mL per day, because you'll need to wake baby up for this amount, and the taste is not well tolerated.
• Formula does contain vitamin D, but if baby is taking less than 32 ounces of formula per day, she still needs the vitamin D supplement.
• 400 IU of vitamin D (via infant drops or 32 ounces of formula) is required every day for the entire first year of life.

Bottle Brush

• Thorough cleaning of the bottles/nipples with soap and water is necessary between feedings, and a specialized brush is very helpful.
• OXO Tot Brush with Stand - effective, cheap, well-reviewed

Bottles and Bottle Nipples

• Two important factors make choosing baby bottles and nipples difficult:
  • Most babies take well to most bottles/nipples, but sometimes trial and error is required to find one your baby likes.
  • Untruthful marketing and general misinformation is rampant.
• Conclusion - We recommend starting out with the bottles/nipples that come with your breast pump. If your baby likes these, there’s no reason to change.
• If your baby doesn’t take to the bottles/nipples that come with your breast pump, the following are good options which meet the criteria outlined in the detailed discussion that follows:
  • Lansinoh
  • Evenflo Classic
  • Philips Avent Anti-Colic - “anti-colic” is a marketing gimmick and has nothing to do with the recommendation.
• Bottles 
  • Bottles should meet the following criteria:
    • Easy to use and clean
    • Cheap
    • Available in small and large sizes
    • Don’t leak
• Bottle Nipples
  • Shape - there are 4 nipple shapes you will find:
    • Narrow - (a.k.a “traditional nipples”)
      • Smaller diameter with a gradual slope from the tip to the base.
      • Most feeding experts agree these are often the best choice for newborns.
      • Narrow nipples, however, mean narrow containers for the milk, which can make the container more difficult to clean.
    • Wide
      • Broader with a more abrupt angle from the tip to the base.
      • Frequently marketed as natural, breast-like, or just like Mom.
      • In reality many babies have trouble latching to these nipples.
    • Gradual
      • Wider base with a gradual slope from the tip to the base.
      • The wider base means a wider container for the milk, which makes the container easier to clean.
    • Specialized (a.k.a. “Orthodontic nipples)
      • Designed to address specific feeding problems.
      • Can cause breastfeeding problems in babies who are not diagnosed with these problems.
      • Unless specifically recommended by a medical professional who has examined your baby, these nipples should be avoided.
  • Flow
    • Generally speaking, the idea is to use slower flow nipples for younger babies, and switch to nipples with increasing rates as babies get older.
    • Unfortunately, there is no industry standard governing flow rates.
    • Despite claims of “slow-flow,” research has shown the actual flow rates vary a lot from one brand to another.
    • Every brand has at least 3 flow rates, and some have up to 6.

Planning for Support

• Lactation consultants are an excellent resource for getting Mom's started on their breastfeeding journey.
• Austin has an fantastic community of these specialists, and you can read more about these options here.

What You Don't Need

Bottle Warmer

• Babies will take breast milk directly from the fridge, provided you get them used to this from the start.
• If you’re set on heating the milk before serving it to your baby, placing the bottle in a bowl of hot water is just as effective as using a bottle warmer.

Bottle and Nipple Sterilizers

• A dishwasher or soap and water will work just fine, while saving you space and money.