Is breast-feeding harder than you expected it to be? Don’t panic. A trained and certified lactation consultant can help. Your body may automatically product breast milk after you give birth, but that doesn’t mean you automatically know how to breast-feed.

Nursing your baby is a skill that involves knowledge as well as instinct. Many women prefer not to breast-feed in public, so it’s a skill you may not have had the chance to observe.

If you’re experiencing challenges with breast-feeding, a lactation consultant can help. When you schedule a consultation, here are some of the top questions to ask.

What is a lactation consultant?

Lactation consultants are usually nurses, doctors, or health professionals who have specific training and certification in assisting with the breast-feeding process. An international board-certified lactation consultant or registered lactation consultant will have IBCLC and/or RLC after their name.

They may see you in their office, in a hospital, or in your home. Some states have free breast-feeding helplines for telephone support from lactation consultants. Many insurance companies cover some of the cost of lactation consulting.

1. Is my baby latching well?

A good latch can make all the difference when you’re breast-feeding. If your baby is latching well, then they’ll be able to get milk out more effectively, which means you’ll be more likely to product the right amount of milk. Plus, a good latch should be comfortable for both you and baby. That means breast-feeding won’t hurt. On the flip side, a poor latch can be painful and ineffective, leading to problems from sore nipples to low milk production.

Luckily, the latch is usually easy to fix. A good lactation consultant can often tell just by watching you breast-feed whether your baby is latching well. But don't panic if your lactation consultant has suggestions for improving your baby’s latch.

If breast-feeding is comfortable and your baby is having regular wet diapers, then you can feel confident that your breast-feeding technique is working, no matter how your latch looks.

2. Am I feeding my baby often enough?

Newborns don’t follow a schedule, and you can’t really breast-feed by the clock. But if you’re worried about how often your baby is eating, your lactation consultant can help. You don’t need to chart every feed to the minute, but it is helpful to know about how many times per day your baby is eating, and how long they’re going between feeds. For the first weeks through the first month, healthy newborn babies eat eight to 12 times a day, every two to three hours.

You can also ask your lactation consultant about signs of hunger, so you can make sure you’re feeding your baby as soon as they demonstrate early hunger cues. These include:

  • opening their mouth
  • smacking their lips
  • turning their head
  • rooting

If you feed your baby immediately when they demonstrate early cues, they’ll be less likely to escalate to crying.

3. Am I producing the right amount of milk?

Not producing enough milk is a worry for many new mothers. Usually, low milk supply is related to a poor latch or not feeding often enough. In these cases, it’s relatively simple to fix. But some women can have trouble producing enough milk due to biological causes like previous breast surgery, genetics, or hormones. Lactation consultants can guide you through the processes of increasing milk supply.

It’s possible to produce too much milk for similar reasons. If your baby seems fussy at the breast and you have concerns about how much milk you’re producing, your lactation consultant can help evaluate whether you may have oversupply or undersupply and make suggestions for managing it.

If you do, the first methods for correcting this are breast-feeding practices like changing how often you feed your baby and fixing any latch problems. If those don’t work, ask your lactation consultant about other options like supplements and medicines.

4. Could my baby have tongue tie?

If there are concerns about your baby’s latch — especially if it’s hurting your nipples when your baby latches or the baby makes a clicking noise when nursing — then be sure to ask your lactation consultant to assess for tongue tie. They are trained to do a full assessment including for tongue tie. It’s a common cause of a poor latch, and it’s very easy to fix.

In order to latch well, your baby needs to be able to extend their tongue out and on top of the bottom lip while they’re sucking. With a tongue tie, the frenulum (the skin that attaches the bottom of your baby’s tongue to the bottom of their mouth) extends a little farther than normal. This makes it difficult for them to extend their tongue, which in turns makes it hard for them to latch correctly.

A simple outpatient operation (called “clipping the tie”) will fix the problem. Your lactation consultant should be able to diagnose it visually by looking at your baby’s tongue and if needed, they can refer to a doctor who can clip it.

5. Can you show me how to use different breast-feeding positions?

Positioning your baby to breast-feed can be a challenge at first. Your newborn is floppy and hard to hold. It’s difficult to figure out exactly how and where to hold them to get them to your breast. But the right position can make latching easier, so position is important.

There are several traditional “breast-feeding holds” that tend to make latching easy for newborns. Ask your lactation consultant to show you several, so you can figure out what works best for you.

The cross cradle hold is the best position to try for new moms. When feeding on the left breast, the baby and baby’s head are held in the right arm and the baby is lying on their side, tummy to tummy. The mom handles her breast with the left hand. The cradle hold for example may tire your arms and shoulders. Use pillows to hold the baby at the correct height and position, taking most of the baby’s weight. The lying down position can be more comfortable for your back and it can also help with an overactive letdown, but it’s often more difficult to master. Finally, the side-lying position is a wonderful way to relax while you breast-feed.

Ask your lactation consultant to help you with a few different positions, so you’ll have options instead of being stuck in the same chair every time your newborn eats.

The takeaway

If you’re having problems breast-feeding, consider hiring a lactation consultant. Asking the above questions may help solve any concerns you have. They can help you and your baby nurse comfortably. 

Q:

Where can women find a trustworthy lactation consultant to work with?

A:

Women should ask in the hospital where they deliver if there’s a lactation consultant available. You can also ask the hospital who is available to see you after you are discharged. Or visit http://www.ilca.org/why-ibclc/falc to find a certified lactation consultant in your area. 

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHTAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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