What is a Lactation Consultant and When Do You Need One?
Aliya’s pregnancy was such a breeze. So was the delivery of her first baby. After being discharged from the hospital, she felt great and was confident that her baby would breastfeed well, particularly as the first few attempts in the hospital were so rewarding.
At home, things did not proceed as she had planned. Aliya was soon exhausted from having to breastfeed every two hours and began to panic that her baby was losing weight. She couldn’t understand why something women have done since the dawn of time could be so challenging.
One of her neighbors in healthcare told Aliya not to give up and to seek out the help of a lactation consultant. She was lucky enough to have insurance coverage for this type of breastfeeding support and soon was back on track with the advice she needed.
Aliya’s story is not unique. Many people struggle with breastfeeding in the first few weeks at home with an infant. It’s normal and common for breastfeeding to be difficult at first but getting help from a lactation consultant can help you reach your goals.
This guide describes what a lactation consultant is and will help you see what kinds of support they provide women at any stage of breastfeeding. You’ll also learn what to expect when talking to a lactation consultant and see the kinds of issues they help you manage.
What is a lactation consultant?
When numerous physician organizations began publicizing the “Breast is best” in the late 1970s, the La Leche League stepped in to help women learn a skill their mothers may not have been able to teach them. These new moms were not always breastfed themselves but wanted to give their babies the most nutritious meals possible.
A grant from the La Leche League led to the development of the International Board of Lactation Consultant Examiners (IBLCE). This organization develops the training and certification needed to become an IBLCE-certified lactation consultant.
Lactation consultants share these characteristics:
- A background in healthcare (often in nursing)
- 95 or more hours of lactation-specific education
- 500 hours of supervised clinical experience in lactation consulting
A lactation consultant can help with many different breastfeeding issues, such as:
- Cracked or sore nipples
- Concern over the amount of milk the baby is getting
- Breast refusal
- Breast positioning
- Breast or nipple pain while breastfeeding
- Inefficient latching on of the infant
- Baby having failed to gain weight
- Breast engorgement and abnormal leakage
- Fatigue from breastfeeding around the clock
- Issues with pumping breastmilk
- Trouble with creating a schedule that includes both breastfeeding and pumping
- Inducing lactation if you haven’t given birth but want to breastfeed
- Infection
- Return to work issues
- Problems with the pace and/or frequency of breastfeeding
Most hospitals have lactation consultants who can visit you after your delivery in your hospital room or lactation room. They can show you how to help your baby latch on and answer your breastfeeding questions before your hospital discharge.
Other lactation consultants can come to your home at any time you have questions or concerns about breastfeeding. Because they have hundreds of hours of training in lactation, they can handle almost any issue you may have at any point from the time of your baby’s first feed until the time of weaning off the breast.
What issues can a lactation consultant help with? When should I see one?
You don’t need to be so frustrated that you want to quit nursing your baby to hire a lactation consultant. They can help enhance the process for you and your baby so that you don’t give up breastfeeding your infant breastmilk before they can eat baby food.
Here are some ways a lactation consultant can help you:
Common “first days” concerns
- Breast positioning. A lactation consultant can evaluate your breasts to see how best to position the baby for feeding. They can show you different positions so you can nurse while lying on your side or when recovering from a cesarean.
- Latching problems. Lactation consultants understand the challenges of training the baby to latch on correctly. Adequate latching prevents many nipple problems from occurring, so this step will help improve your breastfeeding experience and ensure a good intake of breast milk. For example, breastfeeding with flat or inverted nipples can be difficult. This is a situation that a lactation consultant can help with.
- Breast refusal. For various reasons, your baby can be reluctant to nurse, including recent respiratory infections or after using a bottle. Your lactation consultant can help introduce an improved breastfeeding experience for both you and your baby. You can also learn more about what to do if your baby refuses to breastfeed but will take a bottle here.
- Baby’s weight gain. Many women are concerned that their baby isn’t gaining weight. Your lactation consultant can help assess the baby’s nutritional status and reassure you that the baby is getting enough to eat.
- Fatigue and sleep deprivation. This is extremely common after giving birth, especially if there isn’t another parent to feed the baby in the first few weeks of life. The lactation consultant can assess the feeding schedule and advise you on ways to ensure that the baby gets more to eat during the day, needing less while you’re sleeping.
- Managing the pace and frequency of breastfeeding. The lactation consultant can help ensure that you understand how to build up your milk supply to allow the baby to get enough during the daytime hours. This means that the baby won’t need to eat as much at night.
Breast concerns
- Cracked or sore nipples. Most nipple issues come from latching-on problems; however, normal suckling can cause similar concerns. You can learn tips and tricks from the lactation consultant to reduce your pain.
- Mastitis. Mastitis is a breast infection common among breastfeeding women. You need medical attention, certainly, but the lactation consultant can give you direct advice as to how to manage the breastfeeding process as you heal.
- Clogged milk ducts. There are a variety of reasons women may deal with clogged milk ducts and lactation consultants can suggest strategies to help avoid them and clear them if they happen.
Lifestyle and breastfeeding issues
- Problems pumping breastmilk. Breastfeeding and learning how to pump at the same time can be challenging. Whether you’re wondering how much breastmilk you should pump or trying to figure out how to actually do it, a lactation consultant can help.
- Returning to work. Transitioning to work is hard even when you aren’t breastfeeding. If you want to breastfeed as long as possible while working, your lactation consultant can teach you how to pump at work and manage changes in your schedule.
- Feeding more than one baby. Women have successfully nursed more than one baby, but it is more challenging than with one. With hundreds of hours of experience, your lactation consultant can make the challenge easier to manage.
- Feeding versus suckling for comfort. As babies become comfortable with the breast, they can turn to it instead of sucking their fingers or a pacifier. The lactation consultant can help identify ways to teach the baby to use the breast for nursing only.
- Weaning. When you are ready to wean your baby, your lactation consultant can explain the process and help you go through this challenging process.
What should I expect from my lactation consultant appointment?
Lactation consultants can be hired by the hospital or birthing center where you deliver your baby. This can help you get started breastfeeding with plenty of help.
You can also have a consultant come to your home or meet them virtually. Some obstetric clinics have lactation consultants you can see in the office.
When you see the lactation consultant, you should be prepared with questions. Remember that the consultant has seen and heard just about every lactation concern.
Ideally, you would bring your baby so the consultant can watch how the baby latches on and nurses. This will give you the best learning experience.
Lactation consultants are health professionals, so you can expect to have the consultant see you unclothed. They may help you position the baby by touching your breasts as they demonstrate the best latching-on techniques.
How many lactation consultant appointments are typically necessary?
You can visit with your lactation consultant for one visit or as often as you need to get the information and assistance you need. If you need intermittent visits, check to see how much, if any, your insurance will cover.
Kenita Chenevert, IBCLC recommends “being seen at least three times, including one prenatal visit, a visit upon delivery and discharge of the baby, and a follow-up to make sure things are still going well.”
What questions should I ask my lactation consultant?
Be sure to ask for whatever help you need to ensure the best possible breastfeeding experience. Ask any question that might help you understand how to manage current or future challenges you have.
Video vs in-person visits for lactation consulting
A video visit allows the lactation consultant to get insight into how breastfeeding is going for you and your baby.
During a video visit, your lactation consult will:
- Assess a baby’s positioning and latch during a feeding
- Demonstrate tips and tricks for how to hold a baby to get a good position and latch
- Guide you in weighing your baby before and after a feed (if you have a scale that is adequate) to get an idea of how much the baby eats during a feeding
- Help with setting up or using your breast pump, including making sure your pump parts are the right size for you
- Help you with figuring out the ideal diet for breastfeeding, such as what drinks can increase breast milk supply
- Suggest strategies to increase your supply quickly
An in-person visit allows the lactation consultant to get a closer look at any breastfeeding issues so they can provide hands-on assistance.
During an in-person visit, your lactation consultant will:
- Weigh baby before and after a feed to know how much milk baby drinks during a feeding
- Help you with positioning baby at the breast and getting a good latch
- Assess your breasts and baby’s latch or mouth that include a hands-on approach
- Help with setting up or using a breast pump
How much does a lactation consultant cost? Does insurance cover lactation consulting?
The Affordable Care Act of 2010 mandated insurance coverage for all breastfeeding assistance without any cost to lactating moms. This means that if you have any type of health insurance, there is no cost to use a lactation consultant.
If you have no insurance, a lactation consultant will typically cost around $75 to $350 per hour. Most certified consultants, however, will work with you on a sliding scale, if cost is an issue.
Where can I find a lactation consultant?
Lactation consultants can be found at many hospitals that deliver babies. If you’re looking for help after leaving the hospital, there are many options available.
The IBLCE website also offers solutions to finding one of their providers.
Finally, other moms, your midwife, or an obstetrician can give you advice as to where to find the right lactation consultant for your needs.
We asked Kenita Chenevert, IBCLC what to look for when choosing a lactation consultant. Here’s what she had to say:
You should be able to feel comfortable with your lactation consultant. I always suggest having a conversation with them to see if you are able to build a rapport.
Being comfortable with your lactation consultant is very important, especially in such a vulnerable time after you have already bared all with a bunch of strangers who want to do that yet again.
Your breastfeeding journey is unique and one size does not fit all. The same goes for lactation consultants. Every patient has unique needs and should have a lactation consultant that can put those needs first.
Christine Traxler MD is a family physician, lifelong writer, and author with a special interest in mental health, women’s healthcare, and the physical after-effects of psychological trauma. As a contributing writer and editor for numerous organizations, she brings a holistic focus to her work that emphasizes healing and wellness through daily self-care, connecting with others, and setting stepwise goals toward achieving more balanced and authentic lives.
Aliya’s pregnancy was such a breeze. So was the delivery of her first baby. After being discharged from the hospital, she felt great and was confident that her baby would breastfeed well, particularly as the first few attempts in the hospital were so rewarding.
At home, things did not proceed as she had planned. Aliya was soon exhausted from having to breastfeed every two hours and began to panic that her baby was losing weight. She couldn’t understand why something women have done since the dawn of time could be so challenging.
One of her neighbors in healthcare told Aliya not to give up and to seek out the help of a lactation consultant. She was lucky enough to have insurance coverage for this type of breastfeeding support and soon was back on track with the advice she needed.
Aliya’s story is not unique. Many people struggle with breastfeeding in the first few weeks at home with an infant. It’s normal and common for breastfeeding to be difficult at first but getting help from a lactation consultant can help you reach your goals.
This guide describes what a lactation consultant is and will help you see what kinds of support they provide women at any stage of breastfeeding. You’ll also learn what to expect when talking to a lactation consultant and see the kinds of issues they help you manage.
What is a lactation consultant?
When numerous physician organizations began publicizing the “Breast is best” in the late 1970s, the La Leche League stepped in to help women learn a skill their mothers may not have been able to teach them. These new moms were not always breastfed themselves but wanted to give their babies the most nutritious meals possible.
A grant from the La Leche League led to the development of the International Board of Lactation Consultant Examiners (IBLCE). This organization develops the training and certification needed to become an IBLCE-certified lactation consultant.
Lactation consultants share these characteristics:
- A background in healthcare (often in nursing)
- 95 or more hours of lactation-specific education
- 500 hours of supervised clinical experience in lactation consulting
A lactation consultant can help with many different breastfeeding issues, such as:
- Cracked or sore nipples
- Concern over the amount of milk the baby is getting
- Breast refusal
- Breast positioning
- Breast or nipple pain while breastfeeding
- Inefficient latching on of the infant
- Baby having failed to gain weight
- Breast engorgement and abnormal leakage
- Fatigue from breastfeeding around the clock
- Issues with pumping breastmilk
- Trouble with creating a schedule that includes both breastfeeding and pumping
- Inducing lactation if you haven’t given birth but want to breastfeed
- Infection
- Return to work issues
- Problems with the pace and/or frequency of breastfeeding
Most hospitals have lactation consultants who can visit you after your delivery in your hospital room or lactation room. They can show you how to help your baby latch on and answer your breastfeeding questions before your hospital discharge.
Other lactation consultants can come to your home at any time you have questions or concerns about breastfeeding. Because they have hundreds of hours of training in lactation, they can handle almost any issue you may have at any point from the time of your baby’s first feed until the time of weaning off the breast.
What issues can a lactation consultant help with? When should I see one?
You don’t need to be so frustrated that you want to quit nursing your baby to hire a lactation consultant. They can help enhance the process for you and your baby so that you don’t give up breastfeeding your infant breastmilk before they can eat baby food.
Here are some ways a lactation consultant can help you:
Common “first days” concerns
- Breast positioning. A lactation consultant can evaluate your breasts to see how best to position the baby for feeding. They can show you different positions so you can nurse while lying on your side or when recovering from a cesarean.
- Latching problems. Lactation consultants understand the challenges of training the baby to latch on correctly. Adequate latching prevents many nipple problems from occurring, so this step will help improve your breastfeeding experience and ensure a good intake of breast milk. For example, breastfeeding with flat or inverted nipples can be difficult. This is a situation that a lactation consultant can help with.
- Breast refusal. For various reasons, your baby can be reluctant to nurse, including recent respiratory infections or after using a bottle. Your lactation consultant can help introduce an improved breastfeeding experience for both you and your baby. You can also learn more about what to do if your baby refuses to breastfeed but will take a bottle here.
- Baby’s weight gain. Many women are concerned that their baby isn’t gaining weight. Your lactation consultant can help assess the baby’s nutritional status and reassure you that the baby is getting enough to eat.
- Fatigue and sleep deprivation. This is extremely common after giving birth, especially if there isn’t another parent to feed the baby in the first few weeks of life. The lactation consultant can assess the feeding schedule and advise you on ways to ensure that the baby gets more to eat during the day, needing less while you’re sleeping.
- Managing the pace and frequency of breastfeeding. The lactation consultant can help ensure that you understand how to build up your milk supply to allow the baby to get enough during the daytime hours. This means that the baby won’t need to eat as much at night.
Breast concerns
- Cracked or sore nipples. Most nipple issues come from latching-on problems; however, normal suckling can cause similar concerns. You can learn tips and tricks from the lactation consultant to reduce your pain.
- Mastitis. Mastitis is a breast infection common among breastfeeding women. You need medical attention, certainly, but the lactation consultant can give you direct advice as to how to manage the breastfeeding process as you heal.
- Clogged milk ducts. There are a variety of reasons women may deal with clogged milk ducts and lactation consultants can suggest strategies to help avoid them and clear them if they happen.
Lifestyle and breastfeeding issues
- Problems pumping breastmilk. Breastfeeding and learning how to pump at the same time can be challenging. Whether you’re wondering how much breastmilk you should pump or trying to figure out how to actually do it, a lactation consultant can help.
- Returning to work. Transitioning to work is hard even when you aren’t breastfeeding. If you want to breastfeed as long as possible while working, your lactation consultant can teach you how to pump at work and manage changes in your schedule.
- Feeding more than one baby. Women have successfully nursed more than one baby, but it is more challenging than with one. With hundreds of hours of experience, your lactation consultant can make the challenge easier to manage.
- Feeding versus suckling for comfort. As babies become comfortable with the breast, they can turn to it instead of sucking their fingers or a pacifier. The lactation consultant can help identify ways to teach the baby to use the breast for nursing only.
- Weaning. When you are ready to wean your baby, your lactation consultant can explain the process and help you go through this challenging process.
What should I expect from my lactation consultant appointment?
Lactation consultants can be hired by the hospital or birthing center where you deliver your baby. This can help you get started breastfeeding with plenty of help.
You can also have a consultant come to your home or meet them virtually. Some obstetric clinics have lactation consultants you can see in the office.
When you see the lactation consultant, you should be prepared with questions. Remember that the consultant has seen and heard just about every lactation concern.
Ideally, you would bring your baby so the consultant can watch how the baby latches on and nurses. This will give you the best learning experience.
Lactation consultants are health professionals, so you can expect to have the consultant see you unclothed. They may help you position the baby by touching your breasts as they demonstrate the best latching-on techniques.
How many lactation consultant appointments are typically necessary?
You can visit with your lactation consultant for one visit or as often as you need to get the information and assistance you need. If you need intermittent visits, check to see how much, if any, your insurance will cover.
Kenita Chenevert, IBCLC recommends “being seen at least three times, including one prenatal visit, a visit upon delivery and discharge of the baby, and a follow-up to make sure things are still going well.”
What questions should I ask my lactation consultant?
Be sure to ask for whatever help you need to ensure the best possible breastfeeding experience. Ask any question that might help you understand how to manage current or future challenges you have.
Video vs in-person visits for lactation consulting
A video visit allows the lactation consultant to get insight into how breastfeeding is going for you and your baby.
During a video visit, your lactation consult will:
- Assess a baby’s positioning and latch during a feeding
- Demonstrate tips and tricks for how to hold a baby to get a good position and latch
- Guide you in weighing your baby before and after a feed (if you have a scale that is adequate) to get an idea of how much the baby eats during a feeding
- Help with setting up or using your breast pump, including making sure your pump parts are the right size for you
- Help you with figuring out the ideal diet for breastfeeding, such as what drinks can increase breast milk supply
- Suggest strategies to increase your supply quickly
An in-person visit allows the lactation consultant to get a closer look at any breastfeeding issues so they can provide hands-on assistance.
During an in-person visit, your lactation consultant will:
- Weigh baby before and after a feed to know how much milk baby drinks during a feeding
- Help you with positioning baby at the breast and getting a good latch
- Assess your breasts and baby’s latch or mouth that include a hands-on approach
- Help with setting up or using a breast pump
How much does a lactation consultant cost? Does insurance cover lactation consulting?
The Affordable Care Act of 2010 mandated insurance coverage for all breastfeeding assistance without any cost to lactating moms. This means that if you have any type of health insurance, there is no cost to use a lactation consultant.
If you have no insurance, a lactation consultant will typically cost around $75 to $350 per hour. Most certified consultants, however, will work with you on a sliding scale, if cost is an issue.
Where can I find a lactation consultant?
Lactation consultants can be found at many hospitals that deliver babies. If you’re looking for help after leaving the hospital, there are many options available.
The IBLCE website also offers solutions to finding one of their providers.
Finally, other moms, your midwife, or an obstetrician can give you advice as to where to find the right lactation consultant for your needs.
We asked Kenita Chenevert, IBCLC what to look for when choosing a lactation consultant. Here’s what she had to say:
You should be able to feel comfortable with your lactation consultant. I always suggest having a conversation with them to see if you are able to build a rapport.
Being comfortable with your lactation consultant is very important, especially in such a vulnerable time after you have already bared all with a bunch of strangers who want to do that yet again.
Your breastfeeding journey is unique and one size does not fit all. The same goes for lactation consultants. Every patient has unique needs and should have a lactation consultant that can put those needs first.
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