Frequently Asked Questions
What is a lactation consultation?
A lactation consultation is a private appointment about breastfeeding and it can be short, or long. It can take place at your home, my office or via secure video conferencing. You will fill out a medical history with a brief description of the problems you are having. Generally, but not always, I will observe you and the baby or child breastfeeding, with an eye towards the problems you are facing. In other consultations, the focus will be on learning pumping, answering your questions, or a following up from a previous consult.
Is breastfeeding supposed to hurt in the beginning?
While many women report tenderness or soreness in the beginning, which is caused by the nipple stretching out for the first time, or the first time in a long time, it is soreness you can talk and breathe through. If you have pain that causes you to gasp, curl your toes or not want to breastfeed, that is a red flag that something, or several things need adjusting.
How do I know if I have a good latch?
A good latch means good attachment to the breast, not just the nipple.It is a mouthful of breast that positions the nipple far back in the baby’s mouth. Their jaw is wide open and relaxed. When the baby nurses, their jaw moves from front to back, with a visible wave that starts at the chin and ends at the ear. You feel a rhythmic tugging on your nipple. The baby’s cheeks, chin and nose all have good contact with the breast.
A bad latch is like sucking on the nipple like a bottle nipple. You can see the baby's lips and their cheeks dimple in when they suck. The reason a bad latch doesn’t work is because breastmilk does not flow by mere suction like a bottle nipple. Instead milk is induced to flow by compressing and massaging—in other words, ‘milking’—the breast.
Similarly a breast pump does not work by sucking out milk, rather the vacuum stretches and releases the nipple, stimulating the release of oxytocin, which contracts the smooth breast muscle, releasing the milk, and collecting it in the bottle. Yes, pumps suck, but they also release, and that why they are different.
Do you offer in-person consultations?
Yes. All classes and consultations are available in-person in my office and in your home. I am vaccinated against COVID-19 and will wear a mask throughout the appointment to protect you and your family.
Do you offer remote consultations?
Yes. All classes and consultations are available using a secure video chat that is HIPAA compliant.
How can I start working with you?
You can just book a consultation. If you want more information, or to be sure I can really help you in your specific situation, please schedule an interview.
How should I prepare for my lactation consultation?
Preparation varies depending on the location of your appointment and you will receive specific instructions in your appointment confirmation. All appointments require that you fill out an intake form with your health history and take care of payment either by insurance or personal payment.
I suggest you include your partner, husband, wife, or a grandparent at your appointment so they can learn how to best support you in feeding your baby.
How long should I breastfeed my baby?
The American Academy of Pediatrics and the World Health Organization both recommend exclusively breastfeeding infants for the first six months of life.
Despite those recommendations, only about 25.6% of infants are exclusively breastfed in the first six months, and only 35.3% are breastfed throughout one year. Many mothers are not well supported when they have difficulty nursing. And most mothers lack confidence that they have enough milk production.
Any amount of breastfeeding and human milk will reduce your baby’s risks for allergies, asthma, SIDS, childhood leukemia and obesity. And it lowers your risk of postpartum depression and reproductive cancers. The longer and more exclusively you breastfeed, the greater the benefit.
If things are going well, know that humans generally wean on their own between ages 2-6 and it is a highly personal decision for each family to make.
If things are not going well, set short term goals and evaluate whether you have enough support to meet your current challenges. A good lactation consultant will help you evaluate and adjust your overall feeding plan so you don't feel sad, overwhelmed and/or guilty that you are causing harm.
Should I wear a nursing bra while breastfeeding? What kind and how many do I need?
Nursing bras are nice to have for breastfeeding, especially if your breasts are leaky, large and/or heavy. They are comfortable and meet breastfeeding needs of both support, and easy access to a breast. Clips, snaps or hooks allow you to conveniently drop your bra cup while keeping your bra on. Modern fabrics are stretchy, supportive and most of all breathable!
Nursing tanks are an amazing hybrid option when nursing your baby. This stretchy and soft camisole has a built in nursing bra. You can wear them day and night, at home and out in public, alone or layered with a shirt or hoodie. They eliminate that "naked feeling" and boost your confidence to nurse your baby anytime and anywhere.
I recommend having at least three nursing bras and three nursing tanks. "One to wear, one in the wash and one in the drawer." Between leaky milk and spitting up babies, you will be changing your bra and top more than you can imagine.
Wearing a nursing bra or tank is an easy way to hold nursing pads in place and will help keep your tops dry and free of wet of unsightly wet spots.
Help--one of my boobs is bigger than the other!
It’s normal to have a boob that is larger and produces more milk than the other breast. Usually, breasts are about the same size, but some babies have a breast preference, or moms end up nursing more often on one side because they are using their dominant hand to type, eat or something vital.
As long as your baby is gaining weight and your production is adequate, it's more of a cosmetic problem.
If you’re looking to even out how they look, try starting your breastfeeding sessions on the smaller breast to stimulate more milk production. If your baby has a preference for the larger breast, and won't nurse on the other side, try when they are sleepy or breastfeed on the larger breast while pumping with the other.
If giving your smaller boob more love and attention is not evening them out, you can camouflage with a larger bra and padding, or wearing loose-fitting and/or patterned tops.
What if my nipples aren't normal?
Every mom had differences in breast size, the amount of milk each breast produces and of course, different nipples. Usually a baby will figure out how to nurse well on each side, in spite of the differences. It may take a little time, and a lot of patience, and you both may be frustrated while you are learning. The important thing to remember is that babies BREASTfeed. A pronounced nipple can help them locate the milk when they are first learning, but after they are attaching well, it really makes no difference.
If your nipples are very large, (larger than a quarter coin) you may have some pain until your baby grows a bit.
If your nipple is inverted, you may experience pain and cracking while your nipple is everting and stretching out and will then resolve.
If you have nipple piercings, you may find milk leaking through the piercings, or you may feel some discomfort if your baby latches in a particular position. Some people find that a few nipple openings have been closed off by scarring.
If your nipples are flat, you may find that supporting and shaping your breast during attachment makes it easier.
Have a question I didn’t answer here? Please contact me and I’ll be happy to add it to the list.