How to Work with a Virtual Lactation Consultant

Even before the pandemic shifted our entire lives to Zoom, lactation consultants have utilized telemedicine to reach families in the comfort of their own homes. For many of us, all our training, experience, and continuing education allow us the ability to assess and support families with expert care--even remotely. Seasoned lactation consultants have witnessed so many babies nurse and feed. We have seen many cases of damaged nipples and mastitis, and we have supported countless families in meeting their goals and overcoming challenges. Our experience means we know exactly what we are looking for when a three-day-old newborn latches or when a nursing parent is healing from an infection. 

You might be home with your newborn navigating chestfeeding/breastfeeding, pumping, or bottle-feeding, and discerning your own needs for healing and support. You may have painful nipples, a baby that falls asleep very quickly during each feeding, or simply a bunch of questions on how this all works and how you and your baby can thrive. Or maybe you have an older baby or toddler and need support around new behavior (babies are constantly changing!), new challenges, weaning, teething, starting solids, or boosting your supply. All these challenges and more can be addressed virtually with an online lactation consultant!

Many of my colleagues and I have shifted entirely to virtual care--not only because online care is safer in this age of Covid-19--but because online consultations are also convenient and incredibly effective. 

As you anticipate your virtual session with your International Board Certified Lactation Consultant (IBCLC), here are some ways to prepare and get the most out of the relationship:

1. Think of it as a relationship! 

Unlike some providers that see you once and you never talk to again, our profession prides itself on building relationships to support you in your nursing/feeding journey. Ask your lactation consultant how they prefer to stay in touch after the visit, what follow-up is covered in the initial visit fee, and when you may want to see each other again. Many IBCLCs would love to see photos and videos before and after your consultation to get a fuller picture of the challenges you are facing and to see what is already working. Together you will develop a care plan with your consultant. This plan will address your most immediate concerns and also give you support on what is to come in your nursing relationship. This plan is fluid and will change quickly as you and your baby try new things and as your baby (and possibly your milk supply) changes! Communication is key to ensuring that the plan is working for you and your baby. In my private practice, I check in with families the day after we meet to get a sense of what has improved already and to hear about areas that will need further support. Don’t hesitate to reach out or book a follow-up with your consultant!

2. If at all possible, have your partner or a close support person available during the consult to help you.

I have done plenty of solo virtual consults with amazing nursing parents handling their new baby in one hand, and their laptop in another! It can certainly be done, but it’s even better to have someone who can shift camera angles, provide their perspective on how your family is doing and learn about baby development and feeding. If you have a partner, research has shown that supportive partners increase nursing success.  During a pandemic lots of prenatal and postpartum visits are without partners, but your virtual lactation consultation will be better if your partner is fully included and engaged. IBCLCs are all about family-centered care!

3. For your virtual consultation plan to have your baby close by and ideally available to feed. 

This is actually the tricky part whether you see an IBCLC in your home or virtually. Many families ask me how to time a feeding when early nursing and feeding is so unscheduled. First of all, don’t stress. Most visits are scheduled for at least an hour, so if your little one isn’t interested in nursing right away we can talk first and get to nursing a little later. On the other hand, if we all log in to a hungry baby, we can start right away by assessing and assisting with a feeding. I advise families to consider doing a short nursing session to tide the baby over or a small amount in a bottle (if baby is bottle feeding) if the baby is hungry within an hour of our consult. 

4. Gather up all your nursing gadgets and, if you have a breast pump, try to have it out of the box and clean before our visit.

Pumping is one way to help boost supply, relieve engorgement, and have milk available for your baby. There are many tools that nursing parents may use to aid with feeding and promote their own healing. While there is no need to have them all (or any), it can be helpful to bring out what you already have in your home. If you own an infant or kitchen scale, let your lactation consultant know!  At the height of the pandemic, it was not unheard of to ask parents to weigh their baby in a salad bowl to assess intake and growth!  IBCLCs are not only nursing experts, we are pumping and bottle/cup/syringe feeding experts too and knowing the tools you have in your home can help us develop a plan with you for the immediate future. 

5. Consider your own comfort in regards to nursing or having your breasts/chest assessed by video.

There is often a moment in the consult where the nursing parent wonders if it is okay to take off their shirt or bring their baby to the chest. Know that we are sensitive to how vulnerable you may feel and also respect your personal boundaries. Informed consent is incredibly important to us. It may also give you comfort to know that we will not record you without your expressed consent, as prohibited by our professional organization and that we are bound by HIPPA. We will always offer a secure platform for our visit and our communications with you. Nevertheless, you may want a second device handy so your partner can take a photo or short video of a new latch and position that is working for you.  We want you to feel successful each time you nurse, not only during our call. 

6. Take your time and know that we are professionals that understand the emotions of early parenthood. 

Expect non-judgemental and evidence-based support! We know you are exhausted and likely sleep-deprived. We are comfortable with crying babies (and parents). We are ready to meet you where you are and reflect back all the amazing parenting you are doing. It can be helpful to write down some questions you have ahead of time, but also know that we will ask lots of questions as well, to provide you with the best care and recommendations. We want you to know that you are not alone and that, with support, your nursing can get easier, and more comfortable. 

Embrace Virtual!

While I had done limited virtual work prior to Covid-19, I am now embracing a fully virtual practice and being an online lactation consultant. Several months ago, I wouldn’t have believed that I could support families entirely virtually, but I now have clients that I have met when their littles were 3 days old and now we are talking about introducing solids. For me, going all virtual was a leap of faith and I am so honored that families took the leap with me and my colleagues into this brave new world. I have witnessed amazing resilience and resourcefulness in these new families. 

While so much in the world has changed, some things remain the same:  

1. Get help early;  
2. Nursing shouldn’t hurt;
3. We support your feeding goals--and most importantly—

You are not alone!

Kimberleigh Weiss-Lewit MA, IBCLC,CD/CDT(BAI),E-RYT 500, YACEP,  is an International Board Certified Lactation Consultant and a provider on the boober platform. She has worked with breastfeeding parents and babies in Westchester, New York, Northern New Jersey and at Rikers Island Jail.  She is an experienced and certified birth doula, certified birth doula trainer and a trained postpartum doula as well as a prenatal yoga instructor. She has completed advanced training in Perinatal Mood & Anxiety Disorders and Perinatal Loss & Grief and is trained as a Midwife Assistant. She and her husband have 4 children and live in Vermont.