Breastfeeding has so many health benefits for you and your baby but pain, discomfort, and slow weight gain for baby may be making breastfeeding harder than you ever thought. Just like with natural birth, we think that nursing will be easy and intuitive but for most first-time moms (and even experienced moms), it is extremely challenging at first. If you find yourself having trouble nursing, do yourself and baby a favor. Before you give up, see a lactation consultation. In nearly all cases, she will teach you how to continue nursing (comfortably!) for as long as you and baby want. I had a lactation consultant with both of my babies and she made all of the difference!

Before we begin – free gift for you

Click here to download my free guide on the 8 Essential Breastfeeding Tools that helped me go the distance 😉

What is a lactation consultant?

A lactation consultant is a trained professional who can help women learn how to feed their babies. Hopefully, she has met the qualification for, and passed the exam given by, the International Board of Lactation Consultant Examiners (IBCLE).

The term lactation consultant isn’t trademarked, meaning that anyone can use it whether they are certified by IBCLE or not. However, IBCLC (International Board Certified Lactation Consultant) is a registered trademark, so, only board certified lactation consultants will have the letters IBCLC following their name. And since IBCLE is an international organization, the standards and scope of practice for IBCLCs are the same worldwide.

Alternately, someone whose name is followed by CLE or CLC likely took a course that was about a week long but doesn’t have the prior knowledge, experience, or clinical hours that an IBCLC has. IBCLC’s are the gold standard for providing evidence-based lactation support for you and your baby and are especially important if you are having significant problems with milk supply or have a baby that is preterm or has medical challenges.

You may want to see an IBCLC if you are experiencing:

  • any nipple or breast pain – breastfeeding shouldn’t hurt, although a little soreness and discomfort early on may be normal
  • engorgement
  • sore nipples that are not improving
  • redness, pain or swelling in the breasts
  • anxiety about breastfeeding

Or baby is experiencing:

  • inadequate diapers
  • jaundice
  • inadequate weight gain
  • squirms, fusses or cries at breast
  • clicking sounds, hiccups or excessive spit up or vomitting
  • long feeds (45 minutes or longer) and/or frequent feeds (every hour or less) for more than just cluster feeding periods at specific times of day
  • short feeds (5 minutes or less)
  • no interest in nursing for long periods of time
  • incredibly sleepy and won’t wake for feedings or stay awake during feedings
  • trouble latching

Also, if mom feels like something just isn’t right it probably isn’t and it’s time to call the lactation consultant.

How do I find a lactation consultant?

Since many breastfeeding issues require immediate assistance, the quickest way to find an IBCLC is to check the International Lactation Consultant Association’s website and enter your zip code to find one near you.

You can also ask your local La Leche League leader or Breastfeeding USA counselor for a list of local IBCLC’s and she may be able to give input on which lactation consultant is best for your unique situation.

IBCLCs can work in hospitals but many have private practices. A private practice Lactation Consultant is more likely to offer home visits, which is a huge relief when you are struggling to feed your baby, but are less likely to be covered by insurance.

What can you expect during your visit?

A lactation consultation includes one-on-one assessment and hands on breastfeeding instruction. The lactation consultant will assess your babies oral anatomy, looking for tongue and lip ties, which can often be a culprit and hard to diagnose by the untrained eye. She’ll also assess your baby’s general health as well as your breasts and nipples.

Your lactation consultant will also watch your baby feed to assess his latch and offer positioning assistance. You will get lots of practice latching your baby on and learn how to tell when he is really latched, drinking, and swallowing. You can even have your partner video the session on your phone so you can refer to often! Most lactation consultants will weigh your baby before and after a feed with a very sensitive scale to determine exactly how much breastmilk your baby ingested during the feeding. She will answer any questions you have and assess any specific breastfeeding concerns.

If you’ve been exclusively pumping, supplementing with donor milk or formula, or using a nipple shield, a lactation consultant can help get your baby back to breast. On the flip side, if you have a preterm or sick baby that may not be able to latch on to the breast right away, a lactation consultant can help your baby get breastmilk in ways that will help him return to the breast when he is bigger and stronger.

How much do they cost?

A consultation with an IBCLC can range in price from $200 to $350 depending where you live. Sometimes, these consults are for a designated time period but often lactation consultants will stay with you for as long as it takes to get baby hungry and nursing. The price often covers followup emails and phone calls as well. Some lactation consultants may offer packages with additional visits or lengthier phone and e-mail consultation if you and your baby are experiencing difficulties that may require long-term help.

Does insurance cover lactation consultants?

Many insurance companies are beginning to realize that breastfeeding is a public health concern and that covering an IBCLC lactation consultant visit will save on healthcare costs down the road. In fact, the Affordable Care Act requires most insurance plans to cover breast pumps, IBCLCs, and other lactation-related expenses. In practice, many mothers run into problems getting their insurance to pay for visits with lactation consultants.  To help get the cost of lactation consultant covered, consider one or a few of the following tips:

  • Look into working with companies that are liaisons between you and insurance companies. They often have services that will help you get a free breast pump and a free lactation consultant visit.
  • Try to find an IBCLC who is also an RN. Insurance companies seem to look more favorably on this credential despite the fact that IBCLCs are not required to be RNs and there are many fantastic IBCLCs who have no clinical background.
  • Get a referral from your baby’s doctor to see a lactation consultant. This can be a huge help!
  • Call your insurance company in advance to review with them the process of submitting a claim for reimbursement to confirm you’ll have the appropriate paperwork.
  • Check out the National Women’s Law Center for tips about negotiating with insurance companies and template letters to include with your claim for reimbursement of lactation-related expenses.

However, as I mentioned above, many private practice IBCLCs do not seek insurance company affiliation because it is difficult to get paid. In this case, you will have to submit to your insurance after you’ve paid for the consultation. Or, if you that’s not an option, a hospital based IBCLC may be your best bet for getting your visit covered by insurance. However, do keep in mind that many hospital IBCLC’s have to abide by specific hospital rules and regulations which may make it difficult for them to offer advice on some issues, most commonly lip and tongue tie abnormalities in babies. Likewise, it can be difficult to get a one-on-one appointment with IBCLCs affiliated with a hospital.

Overall, it’s important to look at the big picture. The cost of a consult with a lactation consultant is far less than the cost of formula and the likely increase in healthcare costs later in life, so hiring a private practice lactation consultant to work for you alone may be your best bet.

There are also many free options to explore.

  • If you give birth in a hospital or birth center, you may have access to free lactation support from an IBCLC lactation consultant. Take advantage of it even if you don’t think you have a problem. It’s always nice to hear that everything looks good!
  • La Leche League groups are a fantastic resource. LLL leaders are women who have successfully breastfed their baby for 1 year. They can help with some breastfeeding issues and let you know when it’s time to see an IBCLC. Many LLL leaders are also lactation consultants so you may get all the info you need for free. Find your local group here.
  • Breastfeeding USA is similar to La Leche League but is a newer organization so may not cover as wide of a geographic area as LLL.  Breastfeeding USA counselors offer home visits and breastfeeding support groups free of charge. Find one here.
  • Finally, you can find awesome latch and breastfeeding videos on breastfeeding advocate Dr. Jack Newman’s website.

Need breastfeeding help?

How about YOU?

Did you see a lactation consultant? How did she help? Share with us in the comments below.