Many women who choose to breastfeed benefit from having a team of supportive professionals who can provide encouragement, support, and assistance. Your obstetrician can be a valuable part of this team. How can you tell if your OB is supportive of breastfeeding? What should you expect from your OB?

Since there is often a team approach, you may not need your OB unless you have a medical problem with your breasts, such as mastitis. Often, lactation consultants and/or your baby’s pediatrician may be able to manage everything. There do not seem to be as many OBs with lactation consultants in the office as many pediatric offices do.

In some areas, there are breastfeeding medicine specialists/centers that can medically treat both you and your baby. However, prenatally you will have many visits with your OB, and it is helpful if they are supportive of your decision to breastfeed.

The American College of Obstetricians and Gynecologists (ACOG), states that “obstetrician–gynecologists are uniquely positioned to enable women to achieve their infant feeding goals” and “should develop and maintain skills in anticipatory guidance, support for normal breastfeeding physiology, and management of common complications of lactation.” However, I have found that some obstetricians are very knowledgeable and supportive, and others are not. Some are trained in handling problems, especially in a way that protects breastfeeding, and others can treat you but with little regard to whether it harms breastfeeding. For example, in treating an infection or other problem, your OB could choose a medication that is compatible with breastfeeding or choose one where you have to stop for a week.

The level of support in your birth hospital is probably even more important. Do they have lactation consultants on staff? Do they support the new hospital guidelines that are family friendly and breastfeeding friendly? Your choice of OB will also determine your birth location (or vice versa; you may want to choose your hospital/birth center first then choose an OB who delivers there).

Ways you can tell

  • Look around the OB’s office. Are there posters or pictures of women breastfeeding? Are there formula advertisements and coupons or freebies from formula companies? Are there pictures of bottle feeding but not breastfeeding?
  • If they give you free formula or gift bag or diaper bag with formula in it that you don’t ask for, that is not a good sign.
  • Is there a nursing area, or do they say you are welcome to breastfeed here? After all, they see postpartum women in the first 2 months after delivery.
  • Are there breastfeeding articles and links on the practice website?
  • Does the doctor or office show support of breastfeeding on their social media platforms?
  • Do they discuss your feeding plan with you?
  • As a patient, they should be asking you about prior breast surgeries, breast growth during puberty and pregnancy, any prior breastfeeding experience and/or difficulties, and your feeding plan/goals.

The minimum

At bare minimum, your OB should:

  • Support your decision to breastfeed.
  • Be able to tell you where to get help, classes, support groups, lactation consultants/counselors or how to find one.
  • Respect your own goals and values.
  • Not tell you formula is just as good.
  • Give medications compatible with breastfeeding whenever possible.

Questions you could ask

Asking open ended questions would be best. You don’t want to quiz or test your doctor but get their feedback and perspective. Helpful questions include:

  • What is your opinion on breastfeeding? Are there benefits to breastfeeding? Is formula just as good? (They should know the evidence that breastfeeding is better, but not shame someone who can’t or chooses not to).
  • Where would I get help if I need it after I go home?
  • Who can help me in the hospital? (They should definitely know this answer.)
  • Do you/does the hospital support/allow skin-to-skin after delivery, early breastfeeding and delayed procedures?
  • Do you have any recommended books, resources, or handouts on breastfeeding? (Definitely should).
  • Where can I learn more before delivery? Are there classes?
  • What should I do to prepare for breastfeeding?
  • Does birth hospital allow rooming in?
  • Are the medications you routinely give postpartum compatible with breastfeeding?

You could ask more specific questions, such as:

  • How long should I breastfeed? What is recommended?
  • Can you help here with breastfeeding and latch? Make sure I am doing it right? Who here can help? Where can I get help?
  • Where can I get help with pumping and going back to work?

Your OB does not have to be an expert in breastfeeding. They may not have every service or help with every aspect of breastfeeding in the office. However, they should be supportive of your goals and be able to tell you where and when to get help.

References

Optimizing support for breastfeeding as part of obstetric practice. ACOG Committee Opinion No. 756. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;132:e187–96. doi:10.1097/aog.0000000000002890

Vanguri S, Rogers-McQuade H, Sriraman NK, et al. ABM Clinical Protocol #14: Breastfeeding-Friendly Physician’s Office—Optimizing Care for Infants and Children. Breastfeeding Medicine. Published online February 10, 2021. doi:10.1089/bfm.2021.29175.sjv

Hernández-Aguilar M-T, Bartick M, Schreck P, et al. ABM Clinical Protocol #7: Model Maternity Policy Supportive of Breastfeeding. Breastfeeding Medicine. 2018;13(9):559-574. doi:10.1089/bfm.2018.29110.mha

Holmes AV, McLeod AY, Bunik M. ABM Clinical Protocol #5: Peripartum Breastfeeding Management for the Healthy Mother and Infant at Term, Revision 2013. Breastfeeding Medicine. 2013;8(6):469-473. doi:10.1089/bfm.2013.9979