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Bottles & Boobs

What Does a Lactation Consultant Do and Do I Need One?

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Written by Rachel Pierre, new mom and founder of Mommifaceted, a lifestyle brand that addresses the unique challenges that Black moms face.

The decision to breastfeed typically starts during pregnancy for most moms. During pregnancy you start to do research, learn new terms like meconium and colostrum, and start to get advice from other moms and prenatal specialists. Any mom who has breastfed before will tell you, you are probably going to need support even if you don’t realize it. While your body will know what to do to start breastfeeding, most parents who’ve been through it agree, breastfeeding takes practice. That’s where lactation specialists can help. 

Lactation specialists can help make necessary adjustments and offer helpful support to help moms make their breastfeeding journey go more smoothly and hopefully, avoid some of the common challenges. Milk Drunk consulted with Jadah Parks Chatterjee, Registered Nurse, International Board-Certified Lactation Consultant and Bobbie Medical Advisor, to find out more about what lactation consultants do and how they can support new breastfeeding parents. 

What is a Lactation Consultant?

“A lactation consultant is a great support person who is available to help answer all of your infant feeding questions, including anatomy and physiology of the breast/chest, human milk physiology, infant oral anatomy, and safe feeding practices,” advises Chatterjee. 

You can locate a licensed lactation consultant through your child’s pediatrician’s office (who will usually have one on staff) or through the international La Leche League website. 

What kind of help does a Lactation Consultant provide?

The start of breastfeeding brings up a lot of questions as moms begin to navigate this new world. Even with baby number two or three, moms can have a completely different experience than with their first baby, and that is totally normal. Lactation consultants are there to answer each question with specific guidance on your journey. Lactation consultants can help you understand every area of breastfeeding, including latch support, pain during feeding, breast/chest infections and irritation, milk supply and best practices for breastfeeding your baby. 

While a lactation consultant can help you with every aspect of breastfeeding, here are some of the most common issues and concerns Chatterjee sees in her practice.

Pain at the breast or chest during breastfeeding

“The most common issue I support is regarding pain during feeding at the breast/chest,” advises Chatterjee. “I always follow this concern with an assessment of the parent’s breast/chest anatomy and the baby’s oral anatomy.  Often we can remedy the discomfort of the nursing parent with good positions of the baby to support a successful, pain-free latch.  Otherwise, I refer the family to see their pediatrician and occupational therapist for a follow-up assessment and referral for more treatment, as needed.”

Breastfeeding is often portrayed as a beautiful and peaceful bonding experience and not normally associated with pain or uncomfortable feelings. While some discomfort is normal during the early weeks of nursing, most pain should subside within a month. Pain at the breast/chest can include a burning sensation, a feeling of bruising, aching, and rawness around the nipple. As a new mom, you may question if what you are feeling is normal, especially with breastfeeding, and no question is too small to ask your consultant.

Milk supply and availability during breastfeeding

Chatterjee says most parents are very concerned about the supply of breast milk their baby is receiving. Moms ask questions like, “How will I know when they are done feeding?”, “Is my baby drinking enough milk?” and “What happens if they fall asleep during a feeding?” She supports this by educating the parent on the breast/chest anatomy, milk physiology and teaching parents how to recognize when the baby is receiving enough milk. 

These cues include the number of wet diapers the baby is making and determining whether the baby rests well and wakes up on their own to enjoy a meal.

Can a baby breathe while nursing?

At some point, every breastfeeding parent will gaze down at their nursing infant and wonder if they can even breathe with their little nose smooshed against the breast. 

Amazingly, our bodies already have the solution to this question and it is another thing we can take off of our list of concerns. Chatterjee answers this parental concern by reviewing the anatomy of the chest/breast and the oral anatomy and function of the baby’s tongue, mouth, and lips. She also explains breast/chest contact and breathing.

“Many times, parents are told to pull back their breast/chest tissue in order to see the baby’s nose or so the baby can breathe,” says Chatterjee. “This is great information, however, it is not helpful for the well baby (a baby without respiratory concerns) that is attempting to come in contact with the milk ducts.”

“When we pull back the breast/chest tissue, we pull a bit of the milk ducts from the baby’s mouth, and this is a disruption to their suck/swallow function.  I always have the parent and support person pinch their noses and swallow three times (you can try now as well).  You cannot swallow or breathe easily when your nose is obstructed.”

Chatterjee says when you see your baby sucking and swallowing (which can be observed by watching their cheeks, throat, and listening for swallowing noises), then you know your baby is breathing.  

Just like us, babies do not want to sit in uncomfortable positions. If your baby is not feeling cozy while breastfeeding, you will notice them detach and attempt to re-latch in a more comfortable position to help with any breathing concerns. “I see this often with full term, well babies,” says Chatterjee.

While Chatterjee prefers to provide breastfeeding support when the baby is skin to skin with their parent, your lactation consultant may suggest other methods. 

For Chatterjee, skin to skin contact allows the parent and the support person to not only see the baby’s oral anatomy moving in sync with swallowing, but also see their baby’s stomach moving up and down.  

While breastfeeding can be a great time to catch up on social media scrolling or to finish up a favorite show, be sure to check on your baby often if you’re concerned your baby can’t breathe while nursing. Admiring the cutie you just welcomed into the family gives you a chance to watch their movement while feeding. It is normal and acceptable to frequently check in on your baby, especially if your baby was born preterm (before 37 weeks) or has respiratory concerns or until you begin to feel more comfortable that they can breathe easy at the breast.   

How do I know if I need a Lactation Consultant?

If you plan to breastfeed your baby, you should have at least one session with a lactation consultant. Many hospitals and birthing centers will provide you with a consultation before being discharged or allowed to go home. While you may not need support immediately after your baby’s birth, you will eventually have a question or concern that the internet simply cannot answer clearly. Having a contact number handy is a lifesaver when you are sleep deprived, engorged and have a crying and hungry baby on your hands.

While breastfeeding is a natural way to feed your baby, it is a learned practice for both you and your baby and keeping this in mind can help with expectations. Without support and proper instruction, you can both feel frustrated while breastfeeding. There are enough challenges in being a new mom and the thought of not being able to feed your baby, an action that should come naturally, is a major depressor for parents. It does not have to be this way. Any frustration, doubt, questions or concerns can be addressed by the lactation consultant so that you can get back to loving, kissing, squeezing, and bonding with your new baby.

What to expect when working with a Lactation Consultant: Do’s and Don’ts

You likely started getting advice from family and friends beginning the day you announced your pregnancy, but your lactation consultant is truly a trusted source of valuable information and support, specifically on your baby’s feeding journey. Your consultant is in your and your baby’s corner. However, there are some issues that your lactation consultant will likely need to refer out to another professional. 

For instance, Chatterjee says she is often asked about sleep training support. While some lactation consultants may be educated in these areas, this is not one of Chatterjee’s areas of expertise. She does, however, offer information regarding the composition of human milk as it is produced over the course of the day which can help with sleep issues. 

“Your body makes milk all day and all night long,” says Chatterjee. “However, at night, your milk has the most amount of prolactin available, which contributes to increasing and sustaining milk volume and production. The nighttime milk also has the most amount of fat available, which contributes to growth and cognitive development of your child.  ” advises Chatterjee.

Lactation consultants support the entire family by giving both the lactating parent and the baby help in finding a reasonable balance for both parent and baby to get what they need to thrive.  When in doubt, talk to your consultant ahead of your delivery to determine if they are a good fit for you and to understand their personal methods.

Most common questions for a Lactation Consultant

Just like with anything in the motherhood space, every prenatal and postpartum professional has their fair share of stories and best practices. While most lactation consultants could write entire volumes of questions they’ve been asked by their patients, here are some of the most common. 

Should I breastfeed on demand?

Breastfeeding works best when your baby is at your breast/chest frequently. Your body needs nipple stimulation and the removal of the stored milk to continue to release the hormones (prolactin and oxytocin) which in turn produce more milk and increase supply.

Breastfeeding on demand is not only beneficial to your supply, but it’s also a healthy way to ensure your baby is feeding when they are hungry. 

Which foods, drinks or medications are safe to take while breastfeeding?

As a new breastfeeding parent, you have a new awareness of everything that goes into your body. It’s very common for breastfeeding parents to ask their lactation consultant if certain medications, herbs, treatments, foods and drinks are acceptable and safe for them while they are breastfeeding. 

It’s a good practice to contact your lactation consultant about anything new you add to your diet or health stack just to make sure there are no known interactions for breastfeeding parents and their babies. 

Do Lactation Consultants make house calls?

She is often asked if she can see patients in their homes. While she is currently only providing telehealth consults via FaceTime or phone call, she and other lactation consultants can almost always identify and resolve parents’ infant feeding concerns. 

“I always follow up in 24-48 hours, depending on the circumstances of the parent and baby,” advises Chatterjee. “If the concern is not able to be supported via telehealth (usually identified before the appointment), I will refer the patient out to a Lactation Consultant that is providing in-person consults.”  

Nurse Chatterjee says it’s important to remember that parents are still nursing children even during the pandemic! 

The takeaway regarding Lactation Consultants and their services

If you plan to breastfeed your baby, you should find a certified lactation consultant sooner rather than later. The support of a certified lactation consultant can mean the difference between having a positive and successful breastfeeding journey and being able to breastfeed or not. 

Lactation consultants are there to support both the parent and the baby and help you make decisions about how to properly and safely feed your child. If you feel you aren’t getting the lactation support you need, communicate this with your lactation consultant so you can resolve the issue. 

Ultimately, the best way to feed your baby is to make sure they are fed and satisfied. Breastfeeding is not easy for many. Whether you have had a difficult time before or are nervous about this aspect of being a new parent, be assured that there are resources available and there is no need to suffer alone. Your lactation consultant can help make sure you are on the right path to ensuring the health of your baby. 

Verified by Jadah Parks Chatterjee, BS, RN, IBCLC, Nurse, Lactation Consultant and Bobbie Medical Advisor.

Sources:

Get Help | La Leche  

Breastfeeding FAQs: How Much and How Often (for Parents) | Nemours KidsHealth 

Breast-feeding and medications: What’s safe? | Mayo Clinic 

The content on this site is for informational purposes only and not intended to be a substitute for professional medical advice, diagnosis or treatment. Discuss any health or feeding concerns with your infant's pediatrician. Never disregard professional medical advice or delay it based on the content on this page.
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