Breastfeeding Counseling

How I Practice Video Series
Sharon Mass, MD, FACOG

HIP: Breastfeeding Counseling from ACOG on Vimeo.


Counseling a woman about breastfeeding is one of the most important things that I do as an OB/GYN. There are several points in the pregnancy where the OB/GYN can make a significant impact on a patient’s success with breastfeeding. The first place the OB/GYN can make an impact is in the antenatal period. There are many studies that have shown that OB/GYNs that support breastfeeding and communicate that to their patients increase both the initiation and the continuation rates of any and exclusive breastfeeding in those patients. Simply changing the way you ask a patient about her feeding preferences from something like “Are you planning to breast or bottle feed?” to an open-ended question such as “I support breast feeding. Have you considered your feeding options?” It can improve breastfeeding success for that patient. Studies have shown that when patients perceive their doctor prefers breastfeeding, they are far more likely to succeed in their breastfeeding efforts. The second place where the OB/GYN makes a difference is the interpartum and immediate postpartum time period. Avoiding labor interventions when possible, but more importantly looking toward the ten steps that improve breastfeeding success in the hospital period can make a huge difference for the patient. It takes very little time and very little counseling to encourage patients to put their baby skin to skin and to avoid non-medically indicated supplementation in the hospital, to counsel patients, to follow policies, to encourage rooming in, to avoid pacifiers, and other steps that can enhance their breastfeeding success. Finally, when I’m in the office with a postpartum patient I can impact her breastfeeding success by having a good knowledge base about the both the medical issues around breastfeeding as well as medication and forms of contraception that are safe to use in breastfeeding patients. There are wonderful resources out there helping obstetricians and gynecologists assess medications and their safety in breastfeeding. One of the most important is the NIH website called LactMed and I frequently refer to that when a patient comes to me asking if a medication is safe to use in the postpartum period. By communicating with patients the importance of breastfeeding and ways to enhance their success in the antepartum, interpartum, and postpartum periods, I as an obstetrician can dramatically improve my patients’ success with her breastfeeding and improve both the health of the mother and her newborn infant. This is how I practice.


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