How to Choose a Lactation Consultant

How to Choose a Lactation Consultant

Breastfeeding has so many health benefits for new moms and babies, but it’s also a new skill that many moms find challenging (and sometimes, downright demoralizing). If you’re having trouble nursing, are worried about supply issues, or are experiencing any pain while feeding, it’s worth finding a lactation consultant before giving it up all together. Think of it this way: you wouldn't be expected to be a league MVP in the NFL without a coach, and a lactation consultant is the expert coach you deserve for this new season of life.

What Is a Lactation Consultant?

A lactation consultant, or International Board Certified Lactation Consultant (IBCLC), is a certified healthcare professional who specializes in supporting and helping women who are breastfeeding or are experiencing breastfeeding challenges. They have specialized knowledge, skills, and hands-on experience in breastfeeding management and the physiology of lactation. They are clinicians, counselors, and cheerleaders rolled into one, providing a level of care that goes far beyond basic advice.

Lactation consultants provide evidence-based guidance and support to mothers during pregnancy, during the fourth trimester, and throughout the breastfeeding journey. They offer individual consultations where they assess mother and baby’s breastfeeding techniques, help with positioning and latching, offer advice on increasing milk supply, and address any and all difficulties or concerns a mother might have.

Understanding IBCLC and Other Credentials

While you might hear different titles used, it's crucial to understand the distinctions, as the level of training varies significantly.

• International Board Certified Lactation Consultant (IBCLC): This is the highest level of certification and is recognized globally as the gold standard in lactation care. To become an IBCLC, a candidate must complete extensive coursework in health sciences, undergo hundreds to thousands of hours of supervised clinical practice, and pass a rigorous board exam. They are trained to handle a wide range of complex issues, from infant weight gain problems and low milk supply to anatomical issues like tongue-ties, and can work in hospitals, clinics, or private practice.
• Certified Lactation Counselor (CLC) or Specialist (CLS): These professionals have completed significant training (often 45-50+ hours) and passed an exam to demonstrate competency in providing breastfeeding education and support for common challenges. They are an excellent resource for families needing guidance with fundamentals like positioning and latching but are trained to refer more complex medical or anatomical issues to an IBCLC or physician.
• Peer Counselors (e.g., La Leche League Leaders, WIC Peer Counselors): These are typically experienced breastfeeding parents who have received training to provide mother-to-mother support, encouragement, and information for common situations. They offer an invaluable sense of community and shared experience and can be a wonderful first line of support, especially through their free group meetings.

How Do You Find a Lactation Consultant?

Since breastfeeding issues tend to require immediate assistance, time is of the essence. But take a deep breath, because there are a range of options for quickly finding a lactation consultant, and many don’t require enormous effort (you’ve got enough on your plate).

• Check in with your village. Ask friends, family, your obstetrician, midwife, doula, or pediatrician for their recommendations—they’re a great resource for finding a list of trusted lactation consultants in your community.
• Use online directories. There are several national online directories specifically dedicated to helping you quickly find local lactation consultants. Sites like the International Lactation Consultant Association (ILCA) and the United States Lactation Consultant Association (USLCA) have search tools for location consultants near you.
• Reach out to breastfeeding support organizations. Groups like La Leche League International (LLLI) and Breastfeeding USA have resources and directories of certified lactation consultants.
• Crowdsource on your social channels. Consider joining local parenting groups on platforms like Facebook—you can ask for recommendations and may receive valuable suggestions and personal experiences from other parents in your community.
• Contact your insurance provider. If you have health insurance (or if you have Medicaid—lactation services are covered without prior approval), contact your insurance rep for a list of covered providers.

Once you’ve compiled a list of potential lactation consultants, you can research their credentials, experience, and reviews to help you make an informed decision (we’ll cover questions to ask potential providers, below).

In-Person vs. Virtual Consultations: Which Is Right for You?

The rise of telehealth has made lactation support more accessible than ever. Understanding the pros and cons can help you choose the best format for your needs.

In-Person Consultations:

• Pros: Allows for hands-on assistance with positioning, a physical assessment of both parent and baby (including checking for tongue-ties and breast tissue), and the use of a sensitive infant scale for weighted feeds. This is often considered the best option for complex latching issues or initial consultations.
• Cons: Can be more expensive and may require travel when you're newly postpartum. Availability may be limited depending on your location.

Virtual Consultations:

• Pros: Incredibly convenient, often more affordable, and provides immediate access to experts regardless of geography. A consultant can observe you in your natural environment (your favorite nursing chair, your bed) and offer tailored advice for your specific setup. It's excellent for follow-up questions, pumping guidance, and troubleshooting less complex issues.
• Cons: Lacks the ability for hands-on adjustments and physical assessments. Success can depend on having a good internet connection and being able to position your camera effectively.

When to Call a Lactation Consultant

Experiencing breastfeeding challenges can be majorly stressful and deeply emotional, but don’t be scared to reach out for help! A lactation consultant will be helpful if you’re experiencing any of the following:

• Your baby isn’t latching onto to your breast properly
• Feeding your baby is painful (Note: While some initial tenderness can be normal, breastfeeding should NOT be a persistently painful, toe-curling experience.)
• Your nipples are sore, cracked, bleeding, or misshapen after feeding
• Your baby has lost weight or is not gaining weight at the expected rate, per your pediatrician
• Your baby is not producing enough wet and dirty diapers every day, per your pediatrician
• You’re concerned you have milk supply issues (either too little or too much)
• You’re having trouble getting your baby positioned to nurse
• Your baby is falling asleep at your breast, or is refusing to feed
• You’re experiencing mastitis or clogged ducts frequently
• Your pediatrician or the hospital staff has mentioned tongue tie or other tethered oral issues
• Your baby has been diagnosed with reflux or food sensitivities
• You are preparing to return to work and need a plan for pumping and maintaining supply.
• You are feeding multiples (twins, triplets) and need strategies for tandem nursing.
• Your baby was born prematurely or has special health considerations.
• You’d like reassurance that your breastfeeding journey is in working order from an experienced professional

Always remember that lactation consultants are there to support and empower you in your breastfeeding journey. They offer personalized guidance and troubleshooting that address your specific challenges to help you achieve your breastfeeding goals. If you’re unsure whether to call a consultant, don’t hesitate to reach out! They’re experienced professionals who can provide valuable assistance and serious peace of mind.

What Should You Ask a Lactation Consultant?

Before deciding on a lactation consultant, you’ll want to know:

• What are your credentials? (Are you an IBCLC?)
• How much experience do they have working with moms who share your challenges? (e.g., "How many clients with low supply have you worked with in the last year?")
• Do they specialize in certain areas of lactation? (e.g., tongue-tie, feeding multiples, pumping exclusively)
• Are your breastfeeding goals in alignment? (A good consultant supports YOUR goals, whether that's exclusive breastfeeding, combination feeding, or weaning.)
• How accessible are they if you have an urgent need? (What is their policy on follow-up texts, calls, or emails?)
• Do they offer in-person or online consultations?
• How do they feel about formula feeding and supplementation? (Their response should be non-judgmental and focused on what's best for you and your baby's health.)
• Do they take insurance, and if not, what is their fee structure? (Ask about the cost of an initial visit vs. follow-ups.)

Be sure to be straightforward and honest about any specific challenges or questions you may have so that the lactation consultant you ultimately choose to work with is the right fit for your needs.

How to Prepare for Your Lactation Consultation

To make the most of your time with the consultant, a little preparation can go a long way. Here’s a helpful checklist:

• Track a Day of Feedings: Jot down the time and duration of each feeding, and count the number of wet and poopy diapers in the 24 hours leading up to the visit. This data is invaluable.
• Have Your Baby Hungry (But Not Screaming): Try to time the visit so your baby will be ready to eat about 30-60 minutes into the consultation. Avoid giving a full feeding right before they arrive.
• Gather Your Gear: Have everything you typically use nearby: your nursing pillow, any nipple shields, your breast pump (and all its parts), any bottles or supplements you use, etc.
• List Your Questions & Concerns: In the haze of new parenthood, it's easy to forget what you wanted to ask. Write down every single question, no matter how small it seems.
• For Virtual Visits: Set up in a well-lit area with a comfortable place to sit. It can be extremely helpful to have a partner or friend there to act as your "camera person" so the consultant can get clear views of the baby's latch and your positioning.

What Should You Expect During a Lactation Consultation?

We find that pregnancy and childbirth often minimize hang ups that you may have had about your body, personal space, and privacy, but all the same, expect your lactation consultant to get up close and personal.

Your consultant will first assess your baby for possible tongue or lip ties, and ask about their general health and weight gain. They’ll also assess your breasts and nipples (this is no time for modesty—there are hungry mouths to feed—literally!), and ask general questions about your health and lifestyle that could influence milk production.

Your consultant will observe you nursing to evaluate your baby’s latch and offer guidance with proper positioning for effective feeding (this may include physically manipulating and moving your breasts, as well). Your baby will be weighed before and after a nursing session with a very sensitive scale to determine exactly how much milk they’ve ingested while feeding.

Every lactation consultation will vary depending on the consultant’s approach and your specific concerns. But the ultimate goal for any consultant is to support you in your breastfeeding journey, ensuring that both you and your baby have a rewarding experience.

After the Visit: Understanding Your Care Plan and Follow-Up

The consultation doesn't end when the consultant walks out the door. The follow-up is just as important.

• The Written Care Plan: A good consultant will leave you with or email you a detailed, written plan. This should summarize their findings, outline the specific strategies you discussed (e.g., a new latch technique, a pumping schedule), and provide links to reliable resources.
• Implementing the Plan: It can feel overwhelming to try new things. Implement one or two changes at a time. Be patient with yourself and your baby as you both learn.
• Follow-Up Support: Most consultants include a period of follow-up care (often 1-2 weeks) via phone, text, or email in their fee. Do not hesitate to use this! It’s perfect for asking clarification questions or reporting on your progress.
• Scheduling a Follow-Up Visit: For more complex issues, a follow-up visit may be necessary to assess progress and adjust the plan. Discuss this possibility with your consultant.

Does Insurance Cover Lactation Consultants?

While insurance coverage for lactation consultant services can vary depending on your provider and plan, under the Affordable Care Act (ACA) most are required to cover certain preventive services, including breastfeeding support, supplies, and counseling. What does that mean for you? It’s likely that your insurance plan provides coverage for a lactation consultant without copays.

If your insurance plan does not cover these services or you don’t currently have insurance, there are other resources available for support including community clinics, breastfeeding support groups, and other public health services.

Navigating Costs: Superbills, HSAs, and Out-of-Pocket Fees

Understanding the financial side can reduce stress. Here's what you need to know:

• In-Network vs. Out-of-Network: The easiest path is using a consultant who is "in-network" with your insurance. If you can't find one, you may have to pay upfront and seek reimbursement.
• Getting a Superbill: If you pay out-of-pocket, ask the lactation consultant for a "superbill." This is a detailed invoice with specific medical coding that you can submit to your insurance company for potential reimbursement.
• Using FSA/HSA Funds: Lactation consultations and breast pumps are qualified medical expenses. You can use funds from your Flexible Spending Account (FSA) or Health Savings Account (HSA) to pay for them tax-free.
• Typical Costs: Out-of-pocket costs can range from $150-$400+ for an initial in-home visit, which often lasts 90-120 minutes. Virtual and follow-up visits are typically less expensive. While it can seem like a lot, remember it's a healthcare service and an investment in your well-being.

Many new moms find breastfeeding challenging, and ultimately quit nursing earlier than they initially intended. Before you throw in the towel, it’s worth reaching out to a lactation consultant. They can address these challenges, offer support and guidance throughout your breastfeeding journey, and help you achieve your breastfeeding goals.