Many moms think of a lactation consultant as a last resort—someone you call only when everything has gone wrong. In reality, I wish more families came in early, before small issues become big ones. A single session can save you weeks of pain, frustration, and self-doubt.
As a pediatrician with IBCLC training who does lactation consultations regularly, let me walk you through when it makes sense to get help, what actually happens during a visit, and what you can expect to walk away with.
When to See a Lactation Consultant
You don't need to be in crisis to benefit from a consultation. Here are common reasons families come in:
Definitely come in if:
- Breastfeeding hurts beyond mild tenderness in the first few days
- Nipples are cracked, bleeding, or blistered
- Baby can't seem to latch or falls off the breast repeatedly
- Baby isn't gaining weight as expected
- Fewer than 6 wet diapers per day after day 4
- You hear clicking sounds during feeding
- Baby seems frustrated at the breast—arching, crying, pulling away
- You've been told your baby has a tongue tie and want evaluation
- You're in pain and nothing you've tried is helping
Consider coming in if:
- You're a first-time mom and just want to make sure things are going well
- You're returning to work and want to plan your pumping routine
- You're having trouble with bottle refusal or switching between breast and bottle
- Breastfeeding "works" but feels harder than it should
- You had difficulty breastfeeding a previous baby and want proactive support this time
There's no wrong time to ask for help. Earlier is almost always better.
What Happens During a Lactation Consultation
Here's what a typical visit looks like in my practice:
1. We Talk First
I'll ask about your birth experience, how feeding has been going, what's been challenging, and what your goals are. This conversation helps me understand the full picture before I watch a feeding.
2. I Observe a Full Feeding
I'll ask you to nurse your baby while I watch closely. I'm looking at:
- How baby approaches the breast and latches
- The angle of baby's mouth and jaw movement
- Whether baby is actively swallowing
- Your comfort level throughout
- How long baby actively feeds before falling asleep or losing interest
3. I Examine Baby's Mouth
I'll do a gentle oral assessment, checking for tongue tie, lip tie, or anything that might be affecting latch or milk transfer.
4. We May Do a Weighted Feed
This means weighing baby before and after a feeding on a precise scale. The difference tells us exactly how much milk baby transferred during that session. It's one of the most useful data points we can get.
5. I Give You a Plan
Based on everything I observe, I'll give you specific, actionable recommendations. This might include:
- Positioning and latch adjustments (I'll show you, not just tell you)
- A feeding schedule or pump plan
- Whether further evaluation is needed (tongue tie, etc.)
- Follow-up timing
You'll leave with a clear plan, not just reassurance.
What a Lactation Consultant Is NOT
A few common misconceptions:
- We're not there to judge you. I don't care whether you breastfeed for 2 weeks or 2 years. My job is to help you meet YOUR goals.
- We're not going to guilt you about formula. If supplementation is what your baby needs, I'll help you do it in a way that protects your supply if that's what you want.
- We're not going to watch you struggle. If I see a problem, I'll step in gently and help. That's literally what you're there for.
IBCLC vs. Other Lactation Support
You'll see different credentials in the lactation world:
- IBCLC (International Board Certified Lactation Consultant) — The gold standard. Requires extensive clinical hours and passing a rigorous exam. This is the credential I hold in addition to my medical degree.
- CLC (Certified Lactation Counselor) — A shorter training program. Great for basic support but may not handle complex cases.
- Peer counselors — Moms who've breastfed and received basic training. Wonderful for emotional support and general guidance.
For any feeding concern that involves pain, poor weight gain, or suspected tongue tie, I recommend seeing an IBCLC.
How Many Visits Will I Need?
Most families I see need 1–2 visits. Many issues resolve with a single session—especially latch problems where one adjustment makes an immediate difference.
More complex situations (tongue tie evaluation and follow-up, supply building, premature baby feeding plans) may need 3–4 visits over several weeks.
The Best Investment You Can Make
I've had moms tell me a 60-minute lactation consultation changed their entire breastfeeding experience. Problems they'd struggled with for weeks were solved in one visit. That's not magic—it's just the value of having experienced eyes on a feeding, catching things you can't see from your own vantage point.
If breastfeeding is important to you but it's not going well, getting help early is the single most effective thing you can do.