You deserve someone in your corner, mama.
Imagine this: You've just received your driver's license and are given a car. You hop in only to find that it's a stick shift. You've never driven one, you've never watched someone drive one, you're alone… and now you're expected to drive it onto the highway.
That would be ridiculous, right?
Well, it's essentially what we ask of new nursing mothers.
Now, to be fair, most new birth persons won't get into the "driver's seat" completely unfamiliar with breastfeeding. It's likely you will get some lactation support in the hospital after delivery—perhaps a breastfeeding education session or a group class. But during those first days you're exhausted and overwhelmed. Even with hands-on help in the hospital, once you're home it can be easy to forget what you learned and grapple with getting that perfect latch position.
This is why most industrialized countries—except for the U.S.—have a system of postpartum care in place: Spain's cartilla de embarazo, "mother's passport," which provides routine access to a community midwife. Insurance-covered breastfeeding counseling in Sweden. Denmark's health visitor and Belgium's kraamverzorgster, who visit for up to eight hours during the first five days post-birth to check on you and guide lactation.
We're the only ones who expect new mothers to do everything and do it alone. Nursing takes experience and practice. Period. This is why I became a certified postpartum doula, and why I encourage new parents to seek out the care and support of a doula so they can have the most successful fourth trimester possible—especially when it comes to nursing.
Here are some of the ways a postpartum doula can help support your breastfeeding or chestfeeding journey:
1. Help you manage engorgement
At birth, your body will produce colostrum, which is known as "liquid gold." It's named not only for its yellow color, but for its incredible nutrient-dense composition, which helps establish gut flora in your baby's tummy. Even the tiniest amounts are, well, worth their weight in gold for your little one.
It's not until approximately day three that your milk—the free-flowing whitish kind that we typically associate with breastfeeding—is really going to come in. It can be intense. Lactation support is crucial at this point. If the baby doesn't have a sufficient latch, or is unable to efficiently drain the breast for whatever reason, your breasts will balloon and become hard, making it all the more challenging for the baby to feed.
You want to prevent that vicious cycle from happening so your baby can feed freely, your supply can increase (the more milk that goes out, the more milk is produced), and you can avoid painful and problematic clogged ducts. A postpartum doula will be able to provide tips to minimize engorgement, soothe your chest and demonstrate various breastfeeding positions that allow you to nurse more easily.
2. Teach a good latch
Latch: The holy grail of postpartum! A "good latch" is dependent on several things, including how the baby's lips and head are positioned and the depth of your nipple and areola in their mouth; all things you might not know unless someone showed you.
A postpartum doula can teach you nursing best practices, the signs of a successful latch, how to feed if you have protruding, flat or inverted nipples, and the rhythms of a successful nursing session. Breastfeeding can feel odd and uncomfortable at first, but it should never create a wincing, crying out-loud kind of pain or cracked, bloody nipples. That's a sign it's time to call a doula or lactation professional. Same goes for a baby who is losing weight or not gaining weight despite regular breastfeeding sessions.
3. Talk through nipple concerns + care
When we think of breastfeeding, we tend to think of the breast itself. After all, it's in the name, right? The alveoli in your breasts, combined with hormones, are the ones producing and supplying the milk. But your nipples are the true gatekeepers to breastfeeding success.
In fact, the shape of your nipples can impact your ability to feed even more than your breast size (it's a myth that larger breasts produce more milk). Protruding, flat and inverted nipples present unique challenges to breastfeeding. It can be frustrating and disheartening to think you "just don't get breastfeeding," when in reality, challenges might be based on factors out of your control, such as your anatomy. Knowing your nipple shape and what techniques and tools to use—like nipple shields for flat or inverted nipples, for example—can help you successfully initiate breastfeeding.
Doulas are trained on this and other topics, like aggressive letdown, treating clogged ducts and general nipple care. It may surprise you to learn that the dreaded mastitis has more to do with micro tears in your nipple than a clogged duct.
4. Offer evidence-based information on diet + milk supply
Go to any new mama forum online and 50% of the questions are related to milk supply and supplements.
Evidence-based doulas will have a working knowledge of healthy foods that have been shown, through research, to naturally boost and maintain your supply. These are called galactagogues, which include things like oatmeal, chickpeas and brewer's yeast (not beer, as the Internet may lead you to believe). It's our job to rely on available science to empower you to make informed decisions.
For example, if you're eyeballing a particular supplement, we can share resources with you, like LactMed, to review the ingredients. This way, you can better understand what you're taking and whether it's the best bet for your body. I can't stress enough how important that is!
When I had a dip in my supply, I reached for fenugreek. I wasn't a doula at that time, I didn't have a doula, and it was what everyone recommended on my parenting group. I couldn't tell by looking at bottle labels that fenugreek is related to the legume family. I am deathly allergic to peanuts. Thankfully the supplements didn't cause an allergic reaction, but they did cause me to feel unwell and develop painful cystic acne. No wonder: As I later learned, fenugreek is one of the most effective lactogenic herbs, but it also has the most negative side effects. If only I had known about goat's rue!
5. Provide pumping support + a pumping schedule
For most birth persons, a pump will be involved in their postpartum journey. Your doula will be able to walk you through how to use a pump and, most importantly, how to tell if your flange is the right size. The flange is the saucer-and-tube part of the pump that envelops your nipple and areola—too loose and it won't effectively empty your breast; too tight, and it can cause painful chafing and tearing.
Once you have the right flange, your pump can be a powerful tool to jumpstart your milk supply after birth (critical if your baby came early), or to maintain or increase your supply at any point. Pumping allows your partner or other trusted support person to bottle-feed your baby. Alternatively, you may decide to exclusively pump or combination feed by supplementing a formula-based diet with pumped milk. And, of course, pumping is necessary if/when you head back to work outside of the home.
Having a doula support these decisions can be a powerful experience, as they walk you through logistics and outline milk storage safety and handling. Some doulas, myself included, also make a point to educate you on your rights as a pumping parent. Being made to pump in a bathroom is not okay—and it's illegal.
6. Offer relationship-based care—beyond breastfeeding tips + "hacks"
It's important to note that unless additionally certified, postpartum doulas have basic lactation training. Depending on the circumstances, you may need or want someone with more advanced training, including a lactation educator, lactation counselor or IBCLC (the highest level of accreditation). You can certainly use both.
Why I particularly love doulas for lactation support—and love being one—is that doulas offer life-saving, relationship-based care. Nothing else is quite like it. We typically work together for several weeks or months, which gives us a unique and useful perspective on your birth, body, breastfeeding challenges and overall experience. Beyond the mechanics of breastfeeding, we are there to listen and hold space for you. Nursing decisions, milk supply, feeding and pumping politics among family and work—it can all be deeply emotional.
Your breastfeeding or chestfeeding journey is just that. Yours. It's up to you what you do, what you try and who is involved. Whatever that looks like, I hope you won't do it alone or step into it unprepared.
Take that lactation course your hospital is offering. Read a book or blog on lactation ahead of the birth. Think about crafting a postpartum plan just like you would a birth plan. Put a postpartum doula on your gift registry. Make a list of the lactation counselors, educators and IBCLCs available in your area or online should you need them. Check in with your health care provider and local resource centers, too, as many states have programs to help people find low-cost or free doula support. Student doulas may also be able to offer their services for a reduced rate as part of their training. These are all things that can support breastfeeding, and your transition into parenthood, in meaningful ways.
Sometimes you just need a quick answer from an expert. A 20-minute video chat with a (real, trained, not pre-recorded) Tot Squad lactation expert can help with scheduling feedings, boosting supply or general troubleshooting. You don't have to go it alone!
Breast milk test kit
Created for moms, by moms, the Breast Milk Test Kit from Lactation Lab analyzes your breast milk for basic nutritional content like calories and protein, as well as vitamins, fatty acids and environmental toxins to bring you an extra dose of breastfeeding confidence. (Read a Motherly editor's real-life review of how this breast milk analysis works.)
C-section-friendly breastfeeding pillow
The unique L-shape of this support pillow, designed by Motherly in partnership with Ingenuity, is made to hug all shapes and stages of recovery, with c-section moms in mind. No matter how your baby made their big debut, this breastfeeding pillow works as an effective positioner for you and your newborn.
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