Is a Lactation Consultation worth your time and money?

You may be wondering if the time and cost of an appointment with a Lactation Consultant is worth it. Before we start, I want to state that in this blog, I am referring to the gold standard in lactation, the International Board Certified Lactation Consultant (IBCLC). The term “lactation consultant” alone can be used by many individuals with less training. These other professionals are also invaluable in educating and supporting new parents. The IBCLC has the most extensive training. Going into this topic requires another blog for another day. 

An IBCLC consultation is fantastic even if things are going well. I recommend everyone has one consultation in the early weeks to get off to a great start. Most people are in the hospital for 36 hours to 4 days. Only a small portion of that time is devoted to working on feeding with expert help. New parents are also exhausted and this is a hard time to learn. You might have taken a prenatal breastfeeding class and that really puts you ahead but can’t replace on-the-job learning with your new bundle of joy! There is a huge gap in education therefore after leaving the hospital or birthing center.

Here is just a preview of some topics and questions covered in a consultation:

• How to know if your baby is suckling effectively
• Is the latch deep and correct?
• How efficient are the feedings and what is normal to expect from day one of life to week three and onward?
• Milk transitioning (coming in), engorgement management, nipple care, managing plugged ducts & mastitis
• Positioning at the breast
• Newborn reflexes and how they help babies latch
• How to know when your baby is done nursing
• How to know if your baby is getting enough breast milk
• Sleep patterns, feeding frequency 
• Why skin-to-skin and tummy time are so important
• Can you introduce a bottle?
• What is paced bottle feeding (responsive feeding) and why is it so important? (even if you don't breastfeed)
• Can you start pumping?
•  Set up and tutorial for your pump and strategies to increase milk expression
• Flange fitting
• Bottle skills
• Bottle refusal
• Reasons to reach out for lactation support​

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The list above is not exhaustive.  I can’t tell you how many parents have relayed to me that they stopped breastfeeding because they werent sure how to know if their baby was getting enough milk. I also hear many parents stop when they struggle with perceived low milk supply. Sometimes we discuss it further and discover that they actually had a normal milk supply but they did not know this. They didn’t know what to expect or may have been misled by social media. And others could have increased their milk supply with the right support. 

Experienced, qualified support from an IBCLC is invaluable. Support of the right kind from family and friends is also critical in helping a new parent reach their feeding goals. We can’t do this alone. 

So what exactly does an IBCLC do in addition to all this education? What happens in a lactation consultation?

• A thorough medical history of both parent and baby
• History of the delivery
• History of feeding experiences since birth and review of the current problem (if there is one)
• Screening for perinatal mood disorders
• Observation of feeding (breast or bottle or both)
• Basic naked weight to track the growth curve
• Pre-feeding weight and post-feeding weight (calculates how much milk is transferred in the feeding with a sensitive scale) 
• Exam of the lactating parent's breasts/nipples and any limitations to mobility or comfort with handling the baby
• Exam of the baby’s reflexes, body structure, skin, oral anatomy, and function
• Evaluation of the pump equipment and flange fit 
• Evaluation of a bottle feeding session if appropriate
• Discussion of the parents' goals
• A care plan is created with the parent's direction and input
• A summary is sent to the Pediatrician

​All my appointments also come with 2 weeks of follow-up messaging via a secure platform. Most IBCLC’s will include either a week or two of follow up support as well. Many of my clients will still sometimes reach out after this time with simple questions or concerns. I am happy to continue to answer questions. Having reliable support has been shown to be absolutely essential to success in breastfeeding. If there is a complicated question or I can’t answer the question without a new evaluation, I will let people know this to give them the opportunity to schedule an appointment for the best care. 

Simply understanding what is normal and what isn't can really put your mind at ease when you are nursing your new baby. It can allow you to enjoy your nursing relationship. 

The IBCLC evaluates the dyad (parent and baby) and is the only healthcare provider that cares for two people together. Breastfeeding is natural but it is a learned skill for the baby and the parent. Having expert help in your corner can make a huge difference in your success and experience. An appointment with an experienced, qualified IBCLC is always worth way more than it will cost. A great planning strategy can be to ask family or friends to cover the cost of a lacation visit as a baby shower gift. Many insurances will also cover lactation. See this link below for more about your rights to lactation coverage. 
​​Benefits for Breastfeeding Moms: Understanding Health Coverage of Breastfeeding Support and Supplies   

~Cathy Walker, MA, RN, IBCLC

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