What is a Lactation Consultation?

A consult is a private appointment about breastfeeding and it can be short, or long. It can take place at your home, my office or via secure video conferencing. You will fill out a medical history with a brief description of the problems you are having. Generally, but not always, I will observe you and the baby or child breastfeeding, with an eye towards the problems you are facing. In some consults, the focus will be on learning pumping, answering your questions, or a following up from a previous consult.

Is breastfeeding supposed to hurt in the beginning?

While many women report soreness in the beginning, which is caused by the nipple stretching out for the first time, or the first time in a long time, it is soreness you can talk and breathe through. If you have pain that causes you to gasp, curl your toes or not want to breastfeed, that is a red flag that something, or several things need adjusting.

How do I know if I have a good latch?

A good latch means good attachment to the breast, not just the nipple.It is a mouthful of breast that positions the nipple far back in the baby’s mouth. Their jaw is wide open and relaxed. When the baby nurses, their jaw moves from front to back, with a visible wave that starts at the chin and ends at the ear. You feel a rhythmic tugging on your nipple. The baby’s cheeks, chin and nose all have good contact with the breast.

A bad latch is like sucking on the nipple like a bottle nipple. You can see the baby's lips and their cheeks dimple in when they suck. The reason a bad latch doesn’t work is because breastmilk does not flow by mere suction like a bottle nipple. Instead milk is induced to flow by compressing and massaging—in other words, ‘milking’—the breast.

Similarly a breast pump does not work by sucking out milk, rather the vacuum stretches and releases the nipple, stimulating the release of oxytocin, which contracts the smooth breast muscle, releasing the milk, and collecting it in the bottle. Yes, pumps suck, but they also release, and that why they are different.