Enf.ª Patrícia Sancho

Specialist in Maternal 
and Obstetric Health
International Certified Lactation Consultant
Head of Nursing Services Gynaecology/Obstetrics Unit
Doctorate in Educational Sciences

Breastfeeding plan: Preparing yourself with knowledge and care

HPA Magazine 24 // 2025

Pregnancy is a time of profound transformation. As it progresses, it is natural for the woman and her family to focus on the moment of birth. However, the postpartum period, and especially breastfeeding, require equally careful preparation.
It is common for pregnant women to be encouraged to draw up a birth plan. This tool, by enabling informed decision-making, promotes confidence and active involvement in the woman. Applying the same logic, the proposal to create a breastfeeding plan arises – a personalized guide that anticipates needs, prevents challenges and facilitates the beginning of successful breastfeeding.
It can take the form of a simple and clear document, in which the pregnant woman expresses her preferences and expectations regarding her breastfeeding plan. However, more than a fixed document, it is a dynamic tool that promotes informed decisions and respect for the woman's autonomy and choices.
This plan is especially relevant for those who wish to breastfeed, but it can also be adapted to other ways of feeding the newborn. The essential thing is that it promotes a conscious and respectful approach to individual decisions.

Why is it important to develop a breastfeeding plan?
It is during pregnancy that many of the emotions and beliefs related to breastfeeding become more prominent. During this period, natural doubts arise: Will I be able to do it? Is it normal to feel pain? What if the baby doesn't want to breastfeed? What if my milk is weak or insufficient? — legitimate questions that deserve to be addressed with listening, empathy and updated information.
Prenatal preparation for breastfeeding is associated with a higher rate of breastfeeding success, both at the beginning and over time. The scientific evidence is clear: mothers who are informed, set realistic expectations, have a support network and strengthen their confidence in the process, which translates into fewer complications and a greater likelihood of continuing to breastfeed, even when faced with challenges.
The plan does not guarantee that everything will go as expected, but it builds a bridge between expectations and reality, promoting informed decisions aligned with the defined objectives.

Steps to build your breastfeeding plan
A breastfeeding plan can be structured in four main phases: pregnancy, birth, postpartum and return to work.
1. Pregnancy: information and support network
• Get information based on scientific evidence: learn about the composition of breast milk, how it is produced and how to maintain production, how to ensure good milk transfer to the baby, warning signs, prevention of complications and debunk myths such as “breast milk is weak”, “it does not sustain” or “it is normal for it to hurt”.
• Participate in breastfeeding support groups: watching other mothers breastfeeding and sharing experiences helps to normalize the process, face challenges and reinforce confidence.
• Consider consulting a certified lactation consultant (IBCLC): to help you, for example, to learn the technique of manual prenatal colostrum extraction and to learn about useful accessories such as cups, pumps or syringes, among others.
• Identify your support network: involve your partner, friends, family and reference professionals. Save contacts and define how and when you can count on each one.
• Know the breastfeeding policy of the health unit chosen for the birth: institutions with an active breastfeeding support policy and trained professionals offer a significant advantage.
• Set personal goals: do you want to breastfeed exclusively? For how long? Will you pump milk? Under what circumstances? How can this be reconciled with returning to work?

2. Birth: protecting breastfeeding from the beginning
It is essential that the birth plan includes measures to protect the beginning of breastfeeding. This is a defining moment with a direct impact on the beginning of breastfeeding and, therefore, must be carefully protected. Birth and the beginning of breastfeeding are closely linked: the way this moment is experienced impacts the next moment.

3. Postpartum: responding to reality
The immediate phase after birth is intense and challenging. Here are some essential practices:
• Maintain skin-to-skin contact after birth, avoiding separations at least until the first feeding, and rooming-in during hospitalization — this promotes milk production, stabilizes the baby's vital parameters, reduces stress, prevents hypoglycemia, and promotes bonding;
• Prioritize free demand over rigid schedules and periods of time at the breast: the baby breastfeeds whenever he or she shows this need, and if he or she does not show it, performing skin-to-skin contact with the baby and offering him or her “snacks” of expressed breast milk will help;
• Be aware of “Second Night Syndrome” — a time when the baby may become more restless and seek to breastfeed constantly. This opens a window for interventions and offering infant formula. Therefore, recognizing this syndrome is essential to effectively respond to the baby's needs for cuddles, tranquillity, and breastfeeding;
• Request early help in case of pain, difficulty latching on, or insecurity; 
• Do not offer nipples or pacifiers — if necessary, use devices such as a cup or syringe to offer breast milk or human milk from the human milk bank;
• Preparing to return home: planning household chores, meals and visits — the mother needs time and peace of mind to adapt and get to know her baby.

4. Returning to work: planning to continue
This moment can be critical, but with organization it is possible to maintain breastfeeding:
• Start extracting and storing milk a few weeks in advance;
• Know your labour rights regarding breastfeeding and reconcile them with your employer;
• Prepare a portable extraction kit and learn about milk conservation;
• Agree with the person caring for the baby/entity how the expressed breast milk will be offered;
• Continue taking care of yourself: maintaining hydration, adequate nutrition and rest are essential to sustain this process

Conclusion: A Meaningful Plan
Developing a breastfeeding plan involves more than just deciding which breast milk you want to give your baby.
Although the prevalence and duration of breastfeeding in Portugal are not fully known, it is estimated that only 21.8% of babies are exclusively breastfed up to 6 months. The reality shows that many women who want to breastfeed end up giving up, often due to a lack of specialized support.
Just as childbirth requires preparation, breastfeeding also requires time, dedication, patience, trust in the process, and a solid support network.
Every woman and every baby are unique. Each plan should reflect this individuality, with room for adjustments and flexibility. It is up to the health professional to respect the woman's decisions, support with empathy, and act based on the best scientific evidence available.
"Breastfeeding is natural and inherent to our condition as mammals. However, we have lost references and know little about how to breastfeed and how breastfed babies and children behave. Therefore, it is essential to learn, understand, and surround yourself with a support network that sustains this process."