Lactation Consultant

What is a lactation consultant?

A lactation consultant is a health professional who specializes in breastfeeding (chestfeeding) and in offering human milk to infants. You can visit a lactation consultant while you’re pregnant, right after you give birth or several months into breastfeeding. You might need this support most urgently during the first few weeks of your baby’s life. This is when your baby is learning how to nurse, and both of you may need more support.

Breastfeeding is a personal decision, and doing so offers many benefits to both you and your baby. However, challenges like nipple pain or low milk supply make some people stop breastfeeding. Lactation consultants are trained to work with infants and their parents to address any feeding challenges. Getting lactation support can improve your chances of breastfeeding for as long as you choose.

What lactation consulting services are available?

Lactation consultants can offer general breastfeeding support and education. This includes showing you how to position and latch your baby for nursing and kangaroo care (skin-to-skin contact). They can also help you manage a wide range of issues that may come up, including:

• Breast engorgement.
• Oversupply of milk (hyperlactation).
• Low supply of milk.
• Clogged milk ducts.
• Breast inflammation (mastitis), which may or may not lead to infection.
• Nipple blebs.
• Sore, cracked or painful nipples.
• Latching difficulties, including babies with tongue-tie or cleft lip/cleft palate.
• Challenges with expressing milk by hand or with a breast pump.
• Support for babies with low birth weight or slow weight gain.
• Support for babies who refuse the breast or bottle.

How can a lactation consultant help me?

A lactation consultant is trained and certified to help you with any problems or concerns related to breastfeeding your baby and lactating (including weaning). They can offer reassurance and troubleshoot specific issues with you. Your lactation consultant may encourage you and educate you on how to:

• Increase, decrease or maintain your milk supply (depending on your individual needs).
• Recognize your baby’s hunger cues.
• Develop a feeding schedule.
• Help your baby latch.
• Treat sore or cracked nipples.
• Manage breast engorgement.
• Find the best breastfeeding position for you and your baby.
• Check if your baby is gaining weight.
• Pump or express milk by hand or with a breast pump.

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

In general, you can expect your lactation consultant to:

• Visit you within the first few days of giving birth (if you’re staying in a hospital). This time is critical for establishing breastfeeding and for your baby’s weight gain.
• Review your health history and your baby’s health record.
• Watch you breastfeed your baby. They’ll pay close attention to how your baby latches on, sucks, swallows and breathes as they feed.
• Give pointers on positioning and how to become more comfortable breastfeeding.
• Help you with your breast pump and make sure it fits your breasts and nipples properly.
• Answer any questions you have and troubleshoot issues unique to you and your baby.
• Teach you how to know if your baby is getting enough breastmilk and gaining enough weight. These could be things like counting dirty and wet diapers or using a scale to weigh your baby before and after feedings.

Lactation consultants work best when they can interact with you in person. Your consultant will ask if it’s OK for them to watch as you feed your child, and they’ll also ask for permission to touch you as they offer guidance. They’ll explain exactly what they’re doing and why. If you’re uncomfortable with your lactation consultant touching you, don’t hesitate to tell them. They’ll respect your wishes and help you in ways you’re comfortable with.

While in-person consultations are the traditional way to get support, some people find success doing virtual consultations.

How do I find a lactation consultant?

Some hospitals have lactation consultants on staff, while others don’t. 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.

What are common questions to ask a lactation consultant?

It may help to 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 people ask lactation consultants include:

• How do I ease nipple pain or itching?
• How can I get my baby to latch?
• What breastfeeding positions do you recommend?
• How do I obtain or keep an adequate milk supply?
• How can I tell if my baby is hungry?
• How do I know if my baby is eating enough?
• How long should my baby nurse from each breast?
• When do you recommend hand expression of milk or pumping?

How much does it cost to see a lactation consultant?

The cost 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, families need support beyond what their insurance will pay.

Call your insurance company to learn if visiting a lactation consultant is covered under your plan.

What are the different types of lactation support providers?

A lactation support provider (LSP) is a health professional who offers breastfeeding support. There are several different types of LSPs, including lactation consultants. LSPs have some differences in background and training, but they’re all dedicated to helping you breastfeed.

You may work with one or more of these providers depending on your needs:

• Breastfeeding peer counselors. These LSPs focus on supporting individuals and communities. They all have personal experience with breastfeeding and complete anywhere from 20 to 90 hours of training. You can find a breastfeeding peer counselor through organizations like La Leche League.
• Breastfeeding counselors. These providers offer counseling and support, including assessments of breastfeeding position and latch. They work in hospital and community settings. They typically support breastfeeding in babies who are full-term and don’t have specific medical needs. They have 45 to 54.5 hours of classroom training and must pass a rigorous certification exam from an accrediting organization. Specific credentials for breastfeeding counselors include Certified Breastfeeding Specialist (CBS®), Certified Lactation Counselor (CLC®) and Certified Lactation Educator (CLE®).
• Lactation consultants. These LSPs give care across the spectrum of breastfeeding needs. They offer general support but can also help identify and solve issues that might stop someone from breastfeeding. Lactation consultants have extensive education and training. They must pass a rigorous certification exam from an accrediting organization. Specific training requirements and credentials are discussed further in the next section.
• Breastfeeding medicine specialists. These LSPs are physicians with advanced training or experience in helping people breastfeed. They can also diagnose related disorders. Most breastfeeding medicine specialists have certification as lactation consultants or breastfeeding counselors. These providers can diagnose and treat the full range of disorders in babies and breastfeeding parents.

Lactation educators also fall under the umbrella of LSPs, but they don’t work directly with people in a clinical setting. Rather, these professionals teach the public about breastfeeding. They receive training through the Childbirth and Postpartum Professional Association (CAPPA).

How can I become a lactation consultant?

You must pass the International Board of Lactation Consultant Examiners (IBLCE) exam. You’ll then earn the credential of International Board Certified Lactation Consultant (IBCLC®).

To be eligible to apply for the exam, you must have a high school diploma or equivalent and complete the following requirements:

• Health sciences education. This requirement ensures you have a solid foundation of knowledge. You must take courses in 14 different subjects like biology, nutrition and medical terminology.
• Lactation-specific education. This involves 90 hours of education covering topics related to human lactation and breastfeeding. You also need to complete five hours of education centered on communication skills.
• Lactation-specific clinical experience. This involves offering support to breastfeeding families in a supervised setting. For example, you might offer in-person consultations for breastfeeding parents. You’ll need anywhere from 300 to 1,000 hours of clinical experience. The number of hours and level of supervision you need depend on your background and prior experience.

After taking and passing the exam, you’ll need to recertify every five years. The IBCLC commission website provides a detailed guide on recertification that walks you through the steps.

A note from Cleveland Clinic

Breastfeeding is a different journey for everyone. And whether it’s your first child or your fifth, each experience is new in its own way. Lactation consultants understand the joys and challenges of breastfeeding. And they have the knowledge to support you.

Don’t hesitate to reach out to your lactation consultant any time you have questions or concerns. They’ll offer expert guidance — and sometimes simply a listening ear — to help you navigate this time.