This post is a summary of what I’m talking about at a local doula meeting this evening. Anyone that wants to suggest additional ideas please comment. References for many of the facts that I cite can be found in Linda Smith’s book, Impact of Birthing Practices on Breastfeeding.

First and most important, doulas support their breastfeeding clients just by being doulas. Research shows when women have doulas supporting them at their births, they have lower rates of medication use and fewer c-sections. Initiating breastfeeding is much easier when mothers are not also recovering from surgery and babies aren’t groggy from pain medication.

Additional things doulas can do before the birth:
– Talk about choosing a baby doctor. While all doctors will say that they support breastfeeding it is important to look at the what they do – not just what they say. Important questions for parents to ask include how many of this doctor’s patients breastfeed exclusively to 6 months and how many breastfeed beyond a year. For additional indications of how supportive a health care provider is of breastfeeding, check out Dr. Jack Newman’s list.
– Recommend some good books. The new Womanly Art of Breastfeeding (the 8th edition – the earlier editions are not nearly as good) and Breastfeeding Made Simple are both very helpful.
– Connect clients with local peer breastfeeding support groups. La Leche League has meetings at different times and locations in Dane County. Happy Bambino, Meritor, and the Madison Birth Center also have mother support group meetings. While these meetings don’t always focus on breastfeeding it can be a good place to connect with other breastfeeding mamas.
– Talk about the ideas of skin-to-skin care (kangaroo mother care) and biological nurturing. These aren’t the typical images of breastfeeding that women have in our culture so it is easier if they’ve encountered them before giving birth.
– Make sure that families know that formula is not the only alternative to mother’s milk at the breast. When a baby needs supplementation, expressed mother’s milk and donor milk are both better options. If it is important to parents to avoid all formula, they should figure out where they could get donor milk before they are in the crisis situation (like before birth).

After the birth:
– Give mothers confidence. Breastfeeding is a normal thing to do, something that doesn’t take a superwoman. It is easy for a mother to doubt herself, particularly in a hospital setting surrounded by people that seem to know more than she does.
– Remind women that they can choose whether or not they want breastfeeding interventions – just like with birth interventions. These interventions range from being directed to change her position, having her baby/breast moved by someone else, using nipple shields, pumping, or supplementing. The same questions are useful (benefits? risks? alternatives? intuition? doing nothing?).
– Get to know the local lactation professionals. Doulas know their clients well and have a sense of what kind of care is the best fit for them. Get a feel for services and prices and care style so that clients don’t have to do all that research themselves when they are under stress with an unhappy baby and mama.