Breastfeeding and Postpartum Doula Support


Written by: Katie Hoover

10.22.2022


When I was pregnant with my first son, I don’t think I had ever heard the word doula, let alone knew what a doula was.


A doula provides physical and emotional support to a pregnant woman and her partner during pregnancy, during birth, immediately after birth, and often during the postpartum period after the family comes home from the hospital.


The postpartum period can be both exhausting and challenging and is often the time when mothers need the most support, encouragement, and care. Surprisingly, the United States is one of the only industrialized countries to not offer mothers a system for postpartum care. For example, Spain provides routine access to a community midwife, Denmark and Belgium both offer home visits for up to eight hours during the first five days post-birth to check on the mother and baby and also guide lactation.

Throughout the US, postpartum doulas are available to assist mothers and families alike. A postpartum doula can promote breastfeeding while encouraging mothers and can help make breastfeeding a positive experience. A postpartum doula typically comes into your home and is available to help with a variety of things. Postpartum doulas are available to support and help with household chores like laundry, dishes, and preparing simple, nutritious meals, in addition to assisting with diaper changes, burping or soothing the baby, and helping mothers initiate and establish breastfeeding with the baby! (Some doulas even offer overnight services to help YOU get the much needed rest you need!). As the popularity of doulas has continued to rise, research indicates that hiring a doula can indeed encourage and foster positive breastfeeding outcomes.

Here are several ways a postpartum doula can help encourage breastfeeding as written by Mandy Major, PCD(DONA), in the Motherly article: “Six ways a postpartum doula can make breastfeeding easier” (https://www.mother.ly/life/postpartum-doula-for-breastfeeding-help/)


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, 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, cracked, bloody nipples. That's a sign it's time to call a doula or lactation professional. The 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 an 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 in 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 nipp