You may have several choices when choosing someone to do a lactation consultation. Should you see your OBGYN or pediatrician? What about the hospital Lactation Consultant? Or maybe the private practice IBCLC? The answer may surprise you. What should you expect out of a Lactation Consult?
- Initial visits generally last between 1.5 to 2.5 hours. Ask the potential Lactation Consultant how long their initial visits last. Anything under an hour is not long enough. You should expect a complete history of your health, pregnancy, and of your labor and delivery. They should also watch a complete feeding and most times a pre and post feed weight is taken to assess the infant’s milk intake.
- Expect them to have a baby scale. If the office is not equipped with a baby scale then they cannot give you a complete consult. Scales are used to assess if the baby is gaining or losing weight and if they are losing weight, how much. They are used to assess how much breast milk the infant is taking in at each feeding. An infant scale is a must.
- Expect them to observe a full feeding. If you go to your pediatrician for breastfeeding help and they leave the room when you breastfeed, there is no way for them to assess the latch. Sometimes, problems do not arise until the feeding is almost done or sometimes they only exist on one breast or during one position. If they only observe you for a few minutes, they cannot get the full picture. A stethoscope is often used to listen to the suck to swallow ratio. A high suck to swallow ratio could indicate a poor latch and transfer of breast milk.
- Expect them to do a breast assessment. Looking at both breasts will provide important clues. They will check for symmetry, symptoms of breast infections, and signs that your breasts can produce milk. If your nipples are cracked and bleeding, it indicates that the latch or position need to be corrected.
- Expect them to stick their fingers in your baby’s mouth to do an oral assessment. This is done to check the baby’s suck and mouth structures. This is important to do because you cannot tell what’s going on inside the baby’s mouth just by looking at the baby breastfeed from the outside.
- Expect them to teach you about lactation management and help solve breastfeeding problems. They will teach you what feeding cues are, how to tell if your baby is getting enough breast milk, and how to know if you baby is latched properly.
- Expect them to come up with a lactation care plan that you are comfortable with. This may include tips on improving the latch or position of your baby or coming up with a pumping schedule if you are separated from your baby. If you have a low milk supply, they can give you a care plan that will help you increase your supply.
- Expect them to communicate written reports to your health care providers. It is important that all of your health care providers communicate with one other to protect your breastfeeding relationship. It takes a whole team to provide breastfeeding support.
These are just some of the basic things you can expect from a lactation consult. Other things may be added depending on your situation. If you are needing to pump, your lactation consultant should be able to help you pick the proper pump, show you how to use the pump, come up with a pumping schedule, and fit you for the proper flange size. As long as your lactation consultant does these things, you should feel comfortable that you are getting a quality comprehensive lactation consult whether it’s from a pediatrician, OBGYN, private practice IBCLC, or a hospital based IBCLC.