Research has shown that mothers are greatly influenced by what their healthcare providers do and do not say¹.

In 2016 The United States Preventative Services Task Force² recommended that physicians provide interventions during pregnancy and postpartum to support breastfeeding.

One strategy to introduce a conversation about breastfeeding is to simply ask patients during early pregnancy ‘How do you plan to feed your infant?’ Most mothers have made a preliminary decision by early pregnancy whether they will breastfeed or not. After asking her plans for infant feeding, the conversation can segue into the reasons why she is choosing to breastfeed or not. Common barriers to breastfeeding include employment concerns, perceived inconvenience, lack of social support, embarrassment about breastfeeding in public, and a history of breastfeeding problems in the past³.

If she is choosing to not breastfeed, this is an opportunity to dispel any myths or address perceived barriers to breastfeeding success. Women who decide to not breastfeed benefit from informed consent regarding the maternal and infant health risks of not breastfeeding.

Although breastfeeding is ‘natural’, success requires health education for the mother, partner, and any involved family members before the infant is born. Prenatal breastfeeding education needs to include the risks of not breastfeeding, basic breastfeeding skills such as positioning, latch, infant feeding cues, frequency of feedings, and signs of adequate milk intake. Women should also learn how to manage common challenges such as engorgement and sore nipples.

Prenatal education may occur in a formal structured group (class) setting, 1:1 education by the prenatal provider, peer counseling, or other community organizations in the USA such as La Leche League or WIC (Special Supplemental Nutrition Program for Women, Infants and Children).