Why Might I Need a Prenatal OR Postpartum Lactation Consultation?

Why Prenatal Consultation?
While prenatal lactation education and consultation can be useful for all mothers in order to help breastfeeding get off to as smooth a start as possible, for some mothers it can make all the difference! If you have experienced/are experiencing any of the following medical or personal issues, we urge you to consider calling us for a prenatal consultation:

  • Difficulties with breastfeeding a previous child for any reason
  • Polycystic Ovarian Syndrome
  • Infertility/trouble conceiving
  • Hormonal imbalances of any kind
  • Symptoms of hyperandrogenism, including hirsuitism, acne, male pattern baldness, etc.
  • A history of irregular menstrual cycles/amenorrhea
  • Minimal or no breast changes during pregnancy (1 or more cup sizes increase, veining and tenderness)
  • Gestational Diabetes
  • Pregnancy Induced Hypertension
  • Maternal illness (chronic or acute)
  • History of breast surgery or injury (including breast reduction and breast implants)
  • Known fetal genetic or congenital problem
  • History of depression or other mental illness
  • History of sexual abuse
  • Breasts that are unusually shaped or extremely asymmetric in size
  • A planned C-section for any reason
  • Twin/multiple pregnancy

Why Postpartum Consultation?
While most women can benefit from some “fine tuning” during their early breastfeeding experience, certain situations can be resolved much more quickly and easily the sooner they are addressed. If you are experiencing any of the situations listed below, please consider calling as soon as possible, rather than waiting to see if the situation will resolve itself. Finances should not be a barrier to referral, as we can see low income women on a sliding scale basis.

  • A baby who is not latching on within the first 24 hours (please do not use a nipple shield to get a baby to latch before the milk has come in!)
  • A baby for whom supplementation of any kind is recommended.
  • A baby who is not passing meconium, or ceases to stool after the meconium is passed.
  • A baby who is not gaining weight once it appears mature milk has come in.
  • A baby who is losing weight rapidly.
  • Nipples are sore, cracked, bleeding, blistered, scabbed, or painful in any way. Breastfeeding should not be painful and it is not possible to tell if a latch is correct just by looking – if nipples are damaged something is wrong and should be addressed as soon as possible.
  • A baby who resists latching, or is fussy, agitated, or seems uncomfortable at the breast.
  • A baby who is nursing “all the time” and never seems satisfied or contented, even if weight gain is adequate.
  • A premature or near term (36-38 weeks) infant, or an infant in the NICU for any reason.
  • A baby born by caesarean section.
  • A baby with any unusual anatomical or genetic defect – especially midline defects: cleft lip, cleft palate, ankyloglossia, hypospadius, esophageal atresia/tracheoesophageal fistula, imperforate anus, conotruncal heart defects and diaphragmatic hernia.
  • A mother or baby with any illness or condition.

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