Lactation Consultant

What is a lactation consultant?

A lactation consultant is a health professional who specializes in breastfeeding (chestfeeding). Lactation consultants undergo specialized training and certification to offer support, advice and guidance to people who chose to breastfeed. Lactation consultants can help with painful nipples, milk supply, breastfeeding positions and other common nursing problems.

Lactation consultants are usually needed during the first few weeks of your baby's life when they're still learning how to feed from the breast. Lactation consultants can help anyone — first-time parents, surrogate mothers or parents who've already breastfed several children. You can visit a lactation consultant while you are still pregnant, right after you give birth or several months into breastfeeding.

Breastfeeding is a personal decision; however, studies show that challenges such as painful nipples and milk supply are factors in a person's choice to stop breastfeeding. A board-certified lactation consultant is trained to work with infants and their parents to solve any feeding challenges they are experiencing and improve a parent's chances of breastfeeding for as long as they choose.

How does someone become a certified lactation consultant?

Most nurses, midwives and physicians have training in breastfeeding and can offer help, especially after delivery. Some people undergo training to be lactation specialists or lactation counselors. It's OK to receive breastfeeding help from all of these individuals; however, a board-certified lactation consultant describes someone who has achieved a specific certification.

The International Board of Lactation Consultant Examiners (IBLCE) certifies lactation consultants who meet its rigorous criteria and pass its exam. An International Board Certified Lactation Consultant may use IBCLC or RLC after their name. IBLC's complete:

• 90 hours of education covering breastfeeding, anatomy, nutrition and more.
• 1,000 hours of lactation-specific clinical experience.
• A rigorous exam.
• Continuing education hours each year.
• Recertification every five years.

This is considered the most well-known and renowned certification for lactation consultants.

How can a lactation consultant help me?

Breastfeeding can be difficult — both emotionally and physically. Sometimes a lactation consultant's best quality is being a source of emotional support and encouragement. The first few weeks of your baby's life are the most important time for establishing breastfeeding. Your lactation consultant can work with you and your baby to increase your chances of having a long and successful breastfeeding experience.

Some reasons you may make an appointment with a lactation consultant are:

• Breast engorgement.
• Plugged ducts or breast infections like mastitis.
• Sore, cracked or painful nipples.
• Milk supply concerns.
• Struggling with nursing positions.
• Issues with latching, tongue-tie or sucking.
• Your baby isn't gaining weight.
• Pumping either once you return to work or for bottle feeding with breastmilk.
• Your baby refusing the breast.

What will I learn from a lactation consultant?

A lactation consultant is specially trained and certified to help you with any problems or concerns you have related to breastfeeding your baby. They can offer reassurance and troubleshoot specific issues with you. Some things you can expect to learn from your lactation consultant are:

• How to increase or maintain your milk supply.
• Recognizing your baby's hunger cues.
• Determining a feeding schedule.
• Making sure your baby is latched properly.
• Treatment for sore or cracked nipples.
• Treatment for breast engorgement.
• Finding the best breastfeeding position for you and your baby.
• Making sure your baby is gaining weight.
• Using your breast pump to express breastmilk.

What can I expect from my appointment with a lactation consultant?

A lactation consultant works with you to understand your goals for breastfeeding and helps you put together a plan, while also answering any questions you have. Lactation consultants work best when they can touch your breasts and nipples and see how your baby is latching. However, some people still find success doing virtual consultations.

Some hospitals have lactation consultants on staff, while others do not. If you aren't sure if your hospital sends a lactation consultant to your room after you give birth, talk to your nurse or healthcare provider. If your hospital or birthing center doesn't have a lactation consultant on staff, you can hire a private lactation consultant to visit you during your hospital stay. Labor and delivery nurses are also helpful and knowledgeable about breastfeeding and can offer support until a lactation consultant is available.

Every hospital, birthing center and lactation consultant is different. However, there are fairly standard things you can expect from your visit with a lactation consultant.

You can expect your lactation consultant to:

• Visit you within the first few days of giving birth. This time is critical for establishing breastfeeding and for your baby's weight gain.
• Review your health history, pregnancy, delivery and other important information about your baby's health.
• Watch you breastfeed your baby, paying close attention to how your baby latches to your nipple. They will watch how your baby sucks, swallows and breathes as they feed.
• Give pointers on positioning and how to become more comfortable breastfeeding.
• Help you with your breast pump. This isn't always possible, especially if you see a lactation consultant in the hospital. A lactation consultant will look at your flange, the plastic piece that fits over your nipple. An improper fit can impact how much milk you pump.
• Answer any questions you have and troubleshoot specific issues unique to you and your baby.
• Teach you how to identify if your baby is getting enough breastmilk and gaining enough weight. These could be things like counting poopy and wet diapers or using a scale to weigh your baby before and after feedings.

How much does it cost to see a lactation consultant?

The cost to see a lactation consultant varies depending on where you live, what services you need and what kind of insurance you have. Some hospitals include a visit from a lactation consultant as part of your care. Other times, mothers need support beyond what their insurance will pay.

It's best to call your insurance company directly to understand if visiting a lactation consultant is covered under your specific plan. You should specify if your lactation consultant is on staff at the hospital or your pediatrician's office, as those are more likely to be covered. Some insurance plans require preauthorization from your physician. Lactation consultants in private practices are less likely to be covered by insurance. Be sure to understand what is covered and what is not covered so you are not surprised.

How do I find a lactation consultant?

Some lactation consultants work with hospitals, birthing centers or pediatricians. They can often visit you just after you've had your baby or when you're visiting your child's pediatrician. In some cases, lactation consultants are nurse practitioners who complete their certification. Lactation consultants can also have a private practice or own their own business.

Check with your healthcare provider or pediatrician to see if a lactation consultant is on staff or available to you. You can also look on the ILBCE website to locate a consultant in your area. There are thousands of ILBCE-certified consultants in the United States alone. You should also contact your insurance company beforehand if you plan on submitting a claim for a lactation consultant through your insurance.

What are common questions to ask a lactation consultant?

Prepare a list of questions before your visit with a lactation consultant. Some questions may be unique to you and your baby; however, some common questions a lactation consultant is asked are:

• How do I make my nipples feel better?
• What is the best way to get my baby to latch?
• What is the best position to breastfeed?
• How do I increase my milk supply?
• How do I know if my baby is eating enough?
• How long should I feed on each breast?
• Are you supportive of formula feeding if breastfeeding doesn't work?

If you are interviewing a lactation consultant prior to giving birth, talk with the lactation consultant in a comfortable environment to see if your personalities are a good fit. Some questions to ask are:

• How do I begin to breastfeed?
• What are the best positions to breastfeed?
• Does breastfeeding hurt?
• What should I expect in the first few days?
• How will I know if my baby is hungry?
• How do I use my breast pump?
• How will I know something is wrong?
• Can you come to the hospital after my baby is born to help me?
• Are you always available for questions?

A note from Cleveland Clinic

If you choose to breastfeed your baby, lactation consultants can support you and answer your questions. Breastfeeding comes with a unique set of challenges, but a certified lactation consultant will help you and your baby with any feeding issues you have.