Prenatal Breast Care
It is important that women who plan to breastfeed learn as much as they can. As natural as breastfeeding is, the proper technique is a learned art. Women with any shape breast and nipple size can nurse, but women with flat or inverted nipples should prepare them before baby is born. The nipples can be assessed around the sixth month of pregnancy.
It was once thought that prenatal nipple preparation would toughen the nipples and prevent soreness. We now know this supple tissue cannot be toughened and with appropriate latch-on skills after delivery a mom can lessen and often eliminate nipple soreness.
Some mothers who begin nursing their babies have problems. St. Luke's Prenatal Breastfeeding Class, books and talking with other women who have nursed are great resources for learning about breastfeeding and hopefully avoiding these problems.
What to look for during pregnancy in preparation for breastfeeding:
- Common nipple - about 90 percent of pregnant women do not need to do any special preparation.
- Flat nipple - a flat nipple does not always "stick out," although it may when the woman is cold or sexually aroused. Although pregnancy helps to get this kind of nipple ready, many mothers find their babies can grasp hold of the nipple more easily if the mothers have done the Hoffman Technique and worn a breast shell.
- Inverted nipple - an inverted nipple looks like a slit or fold. A partly inverted nipple folds in at one side only. A woman can tell if she has an inverted nipple by gently pinching the nipple at the base using the thumb and forefinger. If the nipple shrinks back, it is an "inverted nipple." Many women with inverted nipples have successfully breastfed, but special preparation is helpful.
- Hoffman technique - place the thumbs at the right and left edges of the areola. While pressing inward slightly, the thumbs are pulled firmly apart. This maneuver is repeated at least four times and then again with the thumbs at the top and bottom of the areola. There is some leakage of colostrum during Hoffman maneuvers - this is normal. If uterine irritability occurs, cease using this technique.
- Breast shells - breast shells can be worn prenatally and are for women with flat or inverted nipples. Contact St. Luke's Lactation Services at (319) 369-8944.
- Nursing bra - the best time for a woman to be fitted for a nursing bra is around week 34 of pregnancy. Cotton flaps, non-elastic straps and no underwires are important features of a nursing bra. Try the bra on before you buy it, you should be able to open the flaps with one hand. The bra should have at least two rows of hooks and eyes so it can be adjusted accordingly.
St. Luke's Breastfeeding Supply Store
St. Luke's Birth Care Center offers a variety of breast pumps, pump parts, nursing pillows and other breastfeeding aids for sale in our Breastfeeding Supply Store.
Podcast Episode: Breastfeeding
Leeann Moses, RN, lactation specialist, joins Dr. Arnold during World Breastfeeding Week to discuss frequently asked questions about breastfeeding. Transcript available here.