What to Expect from an In-Person Lactation Consultant visit

Kimberleigh Weiss-Lewit, MA, IBCLC

Getting a comfortable latch, overcoming nipple pain, dealing with engorgement, making sure your little one is gaining and thriving, setting up your pump, questions about feeding and sleeping—there are many reasons you may have decided to reach out to a Lactation Consultant for an in-person visit. Whether you are bodyfeeding, breastfeeding, pumping, bottlefeeding, or combo-feeding, finding a lactation consultant is an important first step in creating a plan to make feeding your baby a more sustainable and enjoyable experience for both of you.

What does a visit with a lactation consultant look like? While every lactation professional practices a little differently, there are common best practices that your Lactation Consultant will likely follow. 

Here are some things to expect and ways to prepare when we come to visit you and your baby:

1. Expect respect and a non-judgmental approach! 

New parents deserve care that is evidence-based, thoughtful and respects the wishes of the family. Lactation consultants play an important role as skilled practitioners with a deep knowledge of infant feeding who can give you practical support to overcome challenges; they can also provide emotional support as they help you navigate these challenges. 

2. Initial visits will often last an hour or more. 

In-person lactation visits are rarely timed and can range from 1-2+ hours depending on the situation and your and your baby’s needs. The average in-home visit is around 90 minutes. If you are working with a Lactation Consultant who takes your insurance your visit will likely be limited to one hour, but will often include multiple sessions. 

3. Hearing your story.

As Lactation Consultants, we want to know your unique history. Having a full medical background for you and your baby is invaluable information for your Lactation Consultant. We may send you an intake to fill out ahead of time or talk through your background information together. We’ll ask for your baby’s birth weight, subsequent weights, how often they are eating, how often you are pumping or expressing, and the baby’s diaper outputs. If you have a significant medical history, had a challenging pregnancy or birth, or your little one has any medical conditions, be sure to share this information with your Lactation Consultant. 

4. Assessing your baby. 

Your consultant will observe your baby and will often ask your consent to assess your baby’s suck and tongue function by placing a gloved finger in their mouth and feeling the inside of their mouth as they suckle and move their tongue. We may also look for normal newborn reflexes and your baby’s general mobility. Babies use their whole bodies to position themselves and nurse well and their reflexes play an important role in the process. 

5. Assessing you.

In addition to asking questions about your pregnancy, birth, postpartum, and general health, your Lactation Consultant may ask your permission to examine your breasts and nipples. Particularly if you have any pain, we will want to understand the severity and underlying cause to help you start healing and feel better quickly! 

6. Time to feed! 

Probably the most integral part of a lactation visit is having your Lactation Consultant observe and assist with a nursing session (or bottle-feeding session if your baby is bottle-fed and having challenges). Many lactating parents are surprised and relieved that adjustments to position and latch can have a big impact on their comfort and their babies' ability to breastfeed/chestfeed well. Feel free to ask lots of questions and clarify any new latch or position guidance—we want you to be able to continue to get a great, pain-free, or at least improved latch after we leave! 

7. Weight check.

During your consult, your Lactation Consultant will weigh your baby and likely offer a “weighted feed.” This is a process of weighing your little one using a very sensitive professional scale (almost every Lactation Consultant has one in their bag), having your baby nurse, and then weighing again after nursing. Since the scale is so sensitive, it picks up exactly how much your baby took in while feeding. This is important information to have especially if weight gain has been an issue or if you need to know how much to supplement your baby or if you are considering reducing supplementation.

8.  Supplemental feedings.

In addition to observing and assisting with a nursing session, your lactation consultant may teach you how to give supplemental feedings, such as those with a syringe or bottle. We may take a look at your breast pump with you to optimize settings and be sure you have the correct flange size or show you how to hand express your milk. It is our job to make sure that expressing milk and feeding your baby—in all the ways babies can feed—is working for you both.

9. Creating a plan—together. 

Once your little one is fed and (ideally! maybe?) napping, your lactation consultant will answer your questions and be sure you understand what worked well during the session as well as changes you may want to make for future success. Together, we will create a care plan for the coming days and clarify the ways we will connect after the visit to be sure the plan is going well. Your Lactation Consultant may also recommend connecting with other professionals that can support you and your baby and should be able to provide referrals to the right expert. Boober can make it easier to find these care providers when you need them. 

10. Who else should be at the session?

We hope your partner or a support person can join the appointment, too. They often have insights and questions that can assist in our efforts to make feeding more successful. They will also learn tips and tricks to help you feel more comfortable during your feeding sessions. 

11.  Following up.

After your consult is over, our hope is that nursing starts to get much better and much more sustainable! We love to hear about your successes and want to know when things are still hard or new problems emerge. Care plans often need to be adjusted once you and your baby are following our suggestions in real life.  Stay in touch with your Lactation Consultant and schedule a follow-up visit if your challenges persist or if you need more support. 

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Reaching out for professional lactation care, scheduling a consult, and welcoming a new person into your home, especially during the whirlwind of early postpartum, can feel overwhelming. Boober can make the process go smoothly by matching you with a vetted lactation consultant, available to support you quickly. We will meet you where you are and care for you how you need.