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 mom’s 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 mom can remove colostrum 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 more than 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% to 10% 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 of mom and baby due to employment.
To prepare for a home visit, it is best for your baby to not be too hungry or too full. Also, be sure that you are well fed and well hydrated and be as well rested as possible.
The Lactation Consult home visit lasts about 2 hours and includes
Assembling a thorough health history about you and your baby
Listening to your concerns about breastfeeding
A pre and post-feed weighing to determine intake
A physical assessment, of mom and baby, that focuses on any issues that may affect breastfeeding
Observation of a complete feed
Instruction on latch, positioning, hand expression, electric pump use and milk storage, if needed
Provision of printed handouts that address breastfeeding issues
Development of a care plan designed to meet your personal breastfeeding goals—I will help you to develop an individualized plan that works for your specific needs and lifestyle
A comprehensive report that will be sent to your health care provider
Follow-up phone or e-mail consultations (included in initial fee) or return visits (extra fees) if necessary
A commitment to continued follow-up until you are satisfied with your breastfeeding relationship
$130—if the drive is up to 40 miles round trip
$140—if the drive is 40-60 miles round trip
$150—if the drive is greater than 60 miles round trip
Extra fees may apply if the consult takes place significantly outside the Lansing area.
Ongoing phone and e-mail follow-up is included in the initial fee. In person follow-up visits are half price.
Lactation consultant fees may be reimbursed by the family’s insurance provider. I will provide a receipt so the family may submit a claim for insurance reimbursement.
The cost of a lactation consultant is minimal when compared with the cost of artificial feeding.