Do I need a lactation consultant?

By Cindy Baker-Fox, registered nurse and international board-certified lactation consultant at CHOC

In addition to the proven health benefits for mom and baby, breastfeeding can be a wonderful experience that fosters bonding. But in some cases, breastfeeding and breast milk production can be challenging for both mom and baby, and may require assistance from a lactation consultant. The most common concern among moms new to breastfeeding is, “Is my baby getting enough milk?” The process can be difficult or confusing for new moms who are looking for support and education. As a result, some moms may stop breastfeeding earlier than they had hoped. In these cases, it may not be necessary to stop breastfeeding, but rather work with a lactation consultant who can evaluate milk supply, a baby’s breastfeeding skills, and any other factors that may be resulting in breastfeeding issues. They can also provide interventions and follow-up care until the problem, or concern, is resolved.

The difference between lactation consultants and lactation educators

Lactation specialists with the title IBCLC (international board-certified lactation consultants) are clinicians who have received advanced education and training in the fields of lactation, breast anatomy and physiology, infant feeding development, infant oral anatomy, and complex lactation issues and challenges. They have hundreds of hours of experience working with breastfeeding moms and babies. Lactation consultants are usually registered nurses, registered dietitians, feeding therapists, or doctors. Others working in the field of lactation may be trained as lactation educators or lactation counselors. These individuals have more limited training in lactation and breastfeeding than lactation consultants, and they focus mostly on education and support, rather than diagnosis and treatment of complex breastfeeding and lactation issues. A lactation consultant can assess, diagnose and treat many breastfeeding issues. When medications or special therapies are required, the lactation consultant will refer the mom and baby to a specialist who can provide additional care.

Common breastfeeding problems

 The most common breastfeeding problems moms encounter that might require lactation services include:

• Difficult or painful latching
• Low milk supply or too much milk supply
• Infant weight loss (more than 10% loss from birth weight) or inadequate weight gain after two weeks post-birth
• Fussiness at the breast, breastfeeding refusal, and nursing strikes
• Breast or nipple pain and/or infections
• Babies with special feeding needs including premature infants; twins and multiples; infants with medical issues that make latching and sucking difficult; or newborns with hyperbilirubinemia, yellow skin from too much bilirubin in the blood
• Preparing to go back to work or school
• Weaning and formula use
• General breastfeeding education, support and follow-ups

How to find lactation services

Insurance companies, including Medi-Cal and Cal-Optima, are required to provide lactation services and supplies for the mom and baby in the hospital as well as at home. Services may be free or fee-based depending on the lactation provider and the family’s insurance coverage. Many birth hospitals offer free or low-cost breastfeeding clinics and services specifically designed for new moms, newborns and growing infants. Support groups are also common resources provided by birth hospitals. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), a federal program of the USDA, is another critical resource for many moms, and they too provide in-depth breastfeeding services, including consultations, classes, support groups and nutritional services. La Leche League support groups are also a good resource for education and support. They are available in most communities and provide a vital connection to lactation specialists and other breastfeeding moms in the community.

What to do if you need help breastfeeding:

• Talk with your baby’s pediatrician who can evaluate if your baby is gaining weight properly and assess his or her mouth to determine if there are any conditions that might be causing sucking or breastfeeding problems. Many pediatric offices have lactation educators in their practice, or they can refer you to a lactation consultant in the community.
• Contact your insurance company to determine your benefits for lactation services. They may require a referral from your pediatrician.
• Contact your birth hospital or local community hospital to determine if they offer a breastfeeding hotline, breastfeeding workshops, classes or private consultations.
• Call the National Women’s Health and Breastfeeding Helpline: 1-800-994-9662. Offered through the U.S. Department of Health and Human Services, this hotline is designed to address breastfeeding women’s questions. The hotline is available Monday through Friday, 9 a.m. to 6 p.m. ET.
• Call your local WIC office to obtain information about their services and to determine if you qualify for their breastfeeding and nutrition programs.
• Check with your local public health department, county health office, or any special mother/baby program to which you belong to determine if they offer breastfeeding education and support.
• Reach out to a family member, friend, neighbor or co-worker who has breastfed. They may be able to provide you with the help and encouragement you need. You might be surprised to hear that they too had breastfeeding issues, and they might be able to share their tips and wisdom with you.

Breastfeeding help is often just a phone call away. Never hesitate to reach out for help. Working with a lactation specialist may be just the thing you need to help achieve an enjoyable successful breastfeeding experience and reap the benefits associated with breastfeeding.

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