Ask the IBCLC: What to Expect From an In-Home Lactation Consultation

Tips from Ashland Health’s very own resident IBCLC

Breastfeeding can come with its fair share of challenges, and sometimes you best bet is to call in the experts to get to the bottom of the issue. In this case, the expert is a lactation consultant, or an International Board Certified Lactation Consultant (IBCLC). These people are the best of the best, and they are a wonderful resource for mothers who have questions about or are having trouble adjusting to breastfeeding. In order to help you be prepared when he/she knocks on your door, we asked our own IBCLC what mothers can expect from an in-home lactation consultation, and what they can do to get the most out of their visit.

Preparing for and getting the most out of your in-home lactation consultation

What is the structure of a typical in-home visit with an IBCLC?

The structure depends on the goals of the visit. If assessing breastfeeding is the priority, I personally will try to time my arrival around the baby’s hunger. This way, I can set up my feeding scale so I can measure the pre- and post-weight and determine the amount of milk transferred. Feedback is given verbally during the visit, as well as in a personalized document that is emailed to you following the visit. This is helpful because mothers can then share this document with her doctor(s) at later appointments. If your visit includes a pumping assessment, your IBCLC will discuss all aspects of set-up, use, sizing, and care of pumping pieces, and will work with you to develop a plan during the visit. Your IBCLC will also call you two or three days later as a follow up.

Is there anything mothers need to do to prepare for an IBCLC visit?

No. You and your IBCLC will speak in depth over the phone prior to the visit so they can get a detailed health history, details about your labor and delivery, and how breastfeeding or pumping has been progressing so far. Please don’t pick up your house or prepare anything special for—Your IBCLC will only need a firm, flat surface with an outlet nearby for the scale, and a place to wash their hands.

Should spouses/partners be there for the visit, too?

It is beneficial to mothers to have their spouse, partner, or another family member present to listen and ask questions during the visit. I always say that it’s great for a mother to be able to have whoever makes her comfortable involved, but to also remember that this is ultimately her visit.

How long does an average in-home lactation consultation last?

Most visits last around an hour, but could go as long as an hour and a half if you’d like a pumping assessment or if there are special circumstances. Multiple babies may take two hours or more.

What can mothers expect in terms of a follow-up after the initial visit? What if an additional visit is needed?

You should receive a call two or three days after the initial visit to see how things are going, but this is usually just a quick check in. Sometimes a follow-up visit is needed or desired, and often mothers benefit from more than one visit. For example: A mother who is using lactation equipment like a nipple shield may benefit from a second visit once she starts weaning off of the equipment. Or, If a mother had a visit with a lactation consult for breastfeeding in the early weeks after giving birth, she may call for a second visit when she is close to returning to work for a pumping assessment and development of an individualized pumping plan.

If you do wish to schedule a follow-up visit, first make sure to determine whether or not your insurance plan covers multiple visits.

What are some questions mothers can expect to get answers to during a visit with an IBCLC?

Being able to answer the questions and ease the minds of a new mother is one of the best parts of being an IBCLC. Of course every visit is different, but here is a list of common questions mothers can expect to get answers to during a visit with an IBCLC.

Am I doing this right (breastfeeding)?

Is the baby getting milk? How much?

Can you show me how to tell that the baby is getting milk?

How does this look (latch, positioning)?

Is my production on track for my lactation goal?

Am I making enough milk to nurse or pump long term?

How can I juggle pumping and nursing?

How will I fit in my pumping when I am at work?

How might this medication I am taking affect my supply?

How can I boost or decrease my milk supply?

How can I avoid plugged ducts or how can I resolve current plugged ducts?

How can I avoid mastitis? What are the signs?

Why is my baby nursing so frequently?

Why are my baby’s nursing sessions so long/short?

Which is the best pump for my situation?

Am I using the right size flanges/breast shields?

What factors in my personal history may/may not affect my milk supply/my ability to make milk?

How can I avoid/heal soreness?

What products might be a solution for my circumstance?

Do I need to pump and when is the best timing for me to introduce pumping?

What is the right length and interval of my pumping sessions?

How do I store and transport milk?

When do I need to freeze my milk?

When I thaw my milk, how long do I have to use it?
Can I refreeze previously frozen milk?

Do I need a nipple shield or how can I stop using this nipple shield?

Is my baby growing appropriately?

Ashland Women’s Health would be happy to speak with you about your own insurance coverage for lactation services so you can take full advantage of your benefits and get all the help you need to be successful. You can read more about our in-home lactation services here, or contact us directly to schedule your free consultation.