Having Trouble Breastfeeding? A Lactation Specialist Can Help

While it may seem like the most natural thing in the world, successfully breastfeeding your baby is often more challenging than expected. This is especially true if you're breastfeeding for the first time. But even if you consider yourself battle-tested, so to speak, having an expert to guide you through your breastfeeding journey goes a long way.

From giving advice to answering your questions, a lactation specialist can offer you peace of mind and ensure you meet and sustain your breastfeeding goals.

"A lactation consultant is an invaluable partner to a breastfeeding mom's journey. She is a cheerleader, emotional support person, and fairy godmother in one package," said Carole Kramer-Arsenault, R.N., IBCLC, the founder of Boston Baby Nurse.

A lactation consultant is an allied healthcare professional and breastfeeding advocate specializing in providing care, support and assistance for breastfeeding moms. While there is an alphabet soup in the lactation support field, the gold standard credential is the International Board Certified Lactation Consultant, or IBCLC.

"Anyone can call themselves a 'lactation consultant,' but it's best to find one who is an experienced registered nurse or certified as an IBCLC," Kramer-Arsenault advised.

The IBCLC credential demands rigorous requirements that include several hours of college courses, breastfeeding-specific education, 500 to 1,000 hours of experience in assisting breastfeeding parents, depending on the entrance pathway, and passing a board exam. These requirements enable an IBCLC to understand breastfeeding challenges and collaborate to develop a care plan to hit your objectives.

Lactation consultants can provide assistance even before your baby is born until the final days of weaning, though they're usually called in by new parents after the delivery.

"When working with a new parent, we often teach them how to obtain the proper latch and position with breastfeeding to prevent sore nipples and optimize the volume of milk a baby can transfer from the breast," Kramer-Arsenault said.

While research shows the positive benefits of breastfeeding, it doesn't always come easily. The World Health Organization (WHO) and UNICEF recommend mothers breastfeed their baby starting within the first hour of birth, then exclusively breastfeed for six months and continue breastfeeding for up to two years and beyond.

However, in a 2021 WHO report, the organization noted only 44 percent of infants 6 months and younger in a sample of 194 nations were exclusively breastfed.

A 2013 study of almost 1,200 mothers published in the journal Pediatrics found 60 percent of participants stopped breastfeeding earlier than they had wanted. Difficulties with lactation was the top reason given, and included "trouble with infant sucking or latching on," "sore, cracked or bleeding nipples," "breastfeeding too painful," "breasts overfull or engorged" and "breasts infected or abscessed." The second-most common response was nutritional factors, including "I didn't have enough milk," "breastmilk alone did not satisfy my baby," "I had trouble getting milk flow to start," "I was concerned about infant weight gain" and "a health professional was concerned about infant weight gain."

Jessica Shepherd, M.D., an OB-GYN in Dallas and Verywell Health's chief medical officer, explained that a lactation consultant can ease these burdens for moms.

"If you are having trouble with your baby's latch or your milk supply, or if you are experiencing any pain associated with breastfeeding, you can work with a qualified lactation consultant who can help you through your difficulties," Shepherd said. "It is also often helpful to seek support from a lactation consultant early on."

A lactation consultant provides support for all things related to breastfeeding. They help mothers reach breastfeeding goals and learn lactation care through education. For instance, they can assist with several issues moms face, including:

• Troubles with latching
• Engorged nipples
• Milk supply issues
• Sore/damaged nipples
• Slow or no weight gain for babies
• Mastitis/plugged milk ducts
• Supplemental feedings when needed
• When babies are fussy during feedings
• Milk expression
• Milk storage
• Weaning
• Advice regarding breastfeeding equipment
• Breastfeeding schedules on return to work
• Specialist health concerns with infants

Moreover, they help boost the confidence of new mothers.

"A lactation consultant can also serve as an important source of emotional support for new parents who may be struggling," Shepherd confirmed.

The ideal time to work with a lactation consultant is within three days of giving birth. However, you can also see one before the baby is born. The most critical time to develop successful breastfeeding is within the first two weeks of lactation.

The Lactation Network recommends visiting an IBCLC during the first week after giving birth: "Meeting with an IBCLC within the first week helps you to establish the foundational skills of good latch and positioning, and also allows the IBCLC to assess the baby's oral anatomy. They'll answer your questions, troubleshoot any issues, and give you confidence that you're doing amazing—because you are."

Your hospital or birth center may have a lactation consultant on staff or you can consult a lactation consultant in private practice. A visit typically lasts 60 to 90 minutes.

Generally, the consultant asks you about your and your baby's medical history and basic information, including your baby's age and birth weight.

Kramer-Arsenault explained how a lactation consultant might handle your first visit: "The lactation consultant's goal is to observe a breastfeeding session. They start by sanitizing their hands and examining your baby's mouth with gloves on. Next, they will weigh your baby naked and note it in their reports. Afterward, they will put the diaper on your baby and again weigh them in grams."

The next step in this process is the breastfeeding session. The lactation consultant observes how you are breastfeeding on your own and then assists and guides you on best practices for nursing. They also explain how to hold your baby and what your position should be while breastfeeding. The lactation consultant keeps observing and guiding you throughout the consultation process.

Once you finish breastfeeding, they weigh your baby again to measure the milk transfer. Based on the findings, they provide you with recommendations to create a successful feeding session. The lactation consultant typically keeps in touch with you to monitor your progress.

A variety of factors contribute to successful breastfeeding and some are simply out of your control. Although getting help from a lactation consultant can increase your chances of success, breastfeeding might not be what's best for you and your baby's unique circumstances. At the end of the day, a happy parent and a fed baby are what matter most.