Massachusetts Breastfeeding Coalition

Incorporating Breastfeeding into Prenatal Care

On the initial History and Physical, ask:

“Any past surgeries or problems with your breasts?”

“How did you feed your other babies?”

“Have you thought about how you’ll feed this baby?”

“What do you think/know about breastfeeding?”

  • Avoid asking “breast or bottle?” Use open-ended questions.
  • Avoid forcing her to state a clear feeding plan.

If she has breastfed before: “How long did you breastfeed for? Why did you stop? Are you still breastfeeding? Any problems with breastfeeding?” Past problems are a red flag.

“What made you choose bottle feeding?” Acknowledge concerns and explore beliefs. See the Q&A section of our website for suggestions in answering questions.

“Did you know that breastfeeding is healthier for you? It’s linked with a lower risk of breast cancer, ovarian cancer, and osteoporosis. It may also lower the risk of many lifelong chronic diseases in your child, such as diabetes and obesity.”

If mother has a personal or family history of other diseases linked with lower rates of breastfeeding (eg, inflammatory bowel disease), she should know that her child may be at particular risk. You may be the only person to tell her this specific information.

On subsequent visits:

“Are you noticing changes in your breasts?” Use this as an opportunity to tell her that her “Your breasts are getting ready to make milk,” and to continue to explore concerns mentioned earlier. Check nipples for inversion and breasts for asymmetry.

“How does your partner feel about breastfeeding?” Include partner in discussions. Discuss benefits to mother’s health, bonding, and benefits to child’s health. Acknowledge partner’s concerns.

Later visits:

When you tell her what to expect in the hospital: advise her to nurse within one hour of birth, sleep with her baby, and to refuse pacifiers and all supplements, especially in the early weeks. Give her our handout, “Making Milk is Easy” Encourage her to learn all she can about breastfeeding before baby arrives. Make her aware of post-partum resources.