Do You Need a Lactation Consultant?

A lactation consultant can help if

  • Your newborn is not latching onto the breast or is not feeding frequently or effectively enough. Newborns need to nurse 8-12 times per 24 hours to receive enough breastmilk and to properly stimulate breasts to make enough milk. If baby consistently falls asleep at the breast or if swallowing is not heard, milk transfer may be inadequate. It is especially important to future milk supply that milk be effectively removed from the breast during the first few days. Either the baby must be effectively breastfeeding or colostrum can be removed by frequent hand expression.
  • Your baby is feeding more than 10-12 times a day and feeds are lasting longer than 30-40 minutes after the first week.
  • Your newborn has too few wet diapers and/or bowel movements. Normal breastfed newborn voiding during the first two days includes one to two wet diapers and 1-2 stools each day. This typically increases to 3-5 wet diapers and 3-4 stools per day by days 3-5. Stools should be changing to yellow by day 5. By day 6, newborns should have at least 5-6 very wet diapers each day and at least 4 yellow stools each day.
  • Your newborn has lost 10% of his or her birth-weight or has not regained birth-weight by 2 weeks of age. Normal weight loss in the newborn period follows a predictable pattern. Most infants lose no more than 7% of their birth-weight in the first few days. After the fifth day, a baby should begin gaining and usually regains birth- weight by 10 days. After the first two weeks, newborns should be gaining at least 5-7 ounces each week.
  • You have sore or damaged nipples. Normal nipple tenderness peaks at around the third to sixth day postpartum and then resolves by the end of the second week. Any damage to the skin of the breast or nipple should receive immediate attention to avoid further damage.  Your baby should release your nipple in a regular, round, shape, with no pinching, compression or bruising.
  • Your baby is not gaining at the appropriate rate.  After the first two weeks, babies should gain a minimum of 5-7 ounces a week.  4-6 month olds should gain 3.5-5 ounces a week and 6-12 month olds should gain 2-4 ounces a week.
  • Your baby seems especially fussy at the breast or between feedings.
  • You have questions or concerns about your milk supply or about your ability to express milk if needed for separation due to employment.
  • You are experiencing breast pain from plugged ducts or infection.
  • Your baby has any physical challenges that affect breastfeeding such as down syndrome or cleft palate.
  • You have multiples and need extra support with feeding and milk supply.
  • You wish to induce lactation or re-lactate.
  • You have a history of breast surgery and have concerns about milk supply.
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