• Your health care team can be a big help! It's important to do all your recommended follow-up care after your bariatric surgery, especially with your registered dietician, who can follow you throughout your pregnancy. Look for a team that is knowledgeable about weight loss surgery, women's health and lactation issues, says Jeanne Blankenship, MS, RD, Chair-elect of the United States Breastfeeding Committee, and a national expert on bariatric surgery and women’s health issues. And speaking of lactation, Kombol recommends making a prenatal appointment with an International Board Certified Lactation Consultant (IBCLC), so that you can arrange close follow up after your baby is born.
• Know that not every health care provider is going to know about or even ask about your weight loss surgery. Tell them, says Kombol, who recommends that women make sure that every health care provider working with them or their babies knows exactly what type of surgery they had and when it was performed.
• Changes in the breast tissue often occur after significant weight loss. Blankenship notes that some breasts become extremely loose or stretchy after weight loss surgery, to the point where it becomes difficult for baby to latch on effectively. "In this case, the best thing to do is work with a good lactation consultant who can assess the latch and make sure there are no issues related to milk production because of the way the baby is latching on."
• If you've had breast surgery, such as a breast lift, breast reduction or breast augmentation, it's critical to make an appointment with an IBCLC before your baby is born. "Many mothers who have had breast surgery of any type are either told that they will not be able to breast-feed [often by 'someone'], or they are given...inappropriate reassurance [that] 'oh, it will be no problem'," says Kombol. "Any breast surgery carries a risk factor related to breast feeding."
• It's important to know how "normal" breast-feeding can be, especially if you haven't breast-fed before and have never been around anyone who did. In fact, women who've breast-fed after a pre-weight loss surgery pregnancy are usually successful with post-weight loss surgery breast feeding, says Blankenship, because they are familiar with their bodies and the breast-feeding process. "That's going to go a long way towards making them feel comfortable with being able to do it again."
• So learn about lactation. Kombol recommends getting started by hanging out at mother-to-mother breastfeeding support groups, even before your baby is born. Talk to your IBCLC and your baby's health care providers about what you should look for to ensure your baby is gaining well (this may include color and number of wet and dirty diapers, monitoring the baby's weight, and looking at the baby's skin tone and activity level).
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To learn more about breastfeeding, check out these resources from Amazon.com:
The Ultimate Breastfeeding Book of Answers: The Most Comprehensive Problem-Solving Guide to Breastfeeding from the Foremost Expert in North America, Revised & Updated Edition, by Jack Newman, M.D., and Teresa Pitman
Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers, by Nancy Mohrbacher and Kathleen Kendall-Tackett