Top 10 Things Lactation Consultants Want You to Know about Breastfeeding

Lactation consultants want you to know these things because they want you to enjoy your infant feeding relationship.

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By Jessica Altemara

1. Plan To Breastfeed

We don’t mean, decide to breastfeed. We mean, if you want to breastfeed, plan to.


Parents often spend a lot of time educating themselves on, and preparing for, birth. Birth Plans are made. Birth places are toured. Childbirth education classes are taken.


It’s easy to understand why you may not realize planning is needed. Breastfeeding is natural. How complicated can it be?


Well, think of it this way; people do a lot of preparing and planning for birth even though it’s natural to do. Breastfeeding can be like that. Being educated in what you can do to support breastfeeding, as well as when to ask for help, is a really good idea. Put lactation care on your baby registry!


The good news is that, with a little planning and preparation, most people can find success with their breastfeeding goals. By taking charge, you get to define what “success” is to you and what forms of support are the best fit.  It’s important to know ahead of time what these options are and to develop your vision for getting breastfeeding off to the right start because…

Many parents are blown away by how different parenting through breastfeeding is from how they pictured it. Most of us don’t have a truly accurate impression of the 24-hours-a-day needs of a newborn baby until we’re living with one.

2. Lactation Support Varies A Lot

Part  of preparing to breastfeed can include shopping for a lactation consultant -just like for a doula, doctor, or daycare. There are many forms of breastfeeding support!


Although you don’t get to choose who they are, most hospitals do have lactation consultants on hand to help immediately after birth. Freestanding birth centers and homebirth midwives will usually do a home visit within the first 48 hours, for postpartum care, and those people may have some breastfeeding education. All of these people will have a fairly limited amount of time to spend helping specifically with nursing. If things go smoothly, this may be all you need.


If things do not go smoothly, or you’re feeling anxious about really getting things right, additional support may be needed. Most people end up wanting more support than what is received in those first couple days.


Beyond what is built into birth, there are a few ways to access lactation support as you need it. There are support groups with trained peer counselors. Some hospitals have outpatient breastfeeding clinics and there are lactation consultants in some primary care provider’s offices.


How much time someone spends with you and how much access you have to them for questions afterward will vary a lot. It’s worth finding out what you can expect ahead of time as far as depth of care.


There are also private practice lactation consultants. These people often provide consultations during pregnancy, to help in looking at your own history and make a plan specific to you. Some will come to your home after birth and spend hours there working through challenges, fully focused on your breastfeeding goals.


There are many levels of expertise, from community support people, to entry level lactation professionals, to IBCLCs. What different credentials mean and what various options cost out of pocket, can vary a lot, too.


So, as with most healthcare providers, remember that lactation consultants are people, with different approaches, styles, and personalities.


It’s a good idea to shop around ahead of time, know your options, and feel confident with who is helping you through a vulnerable and intense time. And, if you end up with one person who doesn’t seem like a great fit, try another lactation consultant until you find someone who is a good fit. Trust your gut!


Having a trusted relationship will be especially appreciated as you come to terms with the fact that…

3. Babies Don’t Eat Like A Sitcom Baby

Many parents are blown away by how different parenting through breastfeeding is from how they pictured it. Most of us don’t have a truly accurate impression of the 24-hours-a-day needs of a newborn baby until we’re living with one.


Babies often have their days and nights switched, at first. Sometimes they sleep too much and have to be woken to eat. Sometimes babies never want to stop eating. Sometimes they eat and sleep in irregular bursts.


Often, the same baby does each of these things on different days! Newborn babies need MUCH more than to be fed every few hours, changed, and let sleep. Being adaptive and responsive is important to get breastfeeding established.


Part of preparing and developing a relationship with a support team, including a lactation consultant, will involve coming to understand what to expect when it comes to meeting the needs of your newborn.


Babies work very differently from adults -or even toddlers! They really can not tell time and thrive best when not on a schedule. Learning about hunger cues, as well as other normal newborn behavior, will leave you far better equipped to feel confident in understanding if breastfeeding is going smoothly.


People often wonder, “Is baby fussy or hungry? Is this a normal amount of eating?” Having an accurate expectation of the needs of a breastfed baby will help you understand how to meet your own needs, and when to ask for help.

4. Your Milk Doesn’t Come In On Day 3

You’re making milk before your baby is even born!


During pregnancy, your body starts making milk in the second trimester. This milk is called colostrum and it’s thicker and there’s fairly small amounts of it, but it is milk. Colostrum alone is enough for the first few days.


Many lactation consultants dislike the language of milk “coming in” because it makes it sound like there isn’t milk prior to that.  We prefer to say milk “begins to transition” sometime around day 3-5 postpartum.


In most cases it is around this time that milk starts to change and become more like the milk we are familiar with. While this is what babies drink long term, the colostrum your body produces in those first few days is the original milk and it is absolutely good enough to exclusively feed a newborn for those early days.


When this is understood and babies are supported in frequent nursing, a strong supply can be established.


All of this is manageable because…

If you have enough pain to shy away from directly latching your baby, it is time to ask for help. Breastfeeding should be both comfortable and comforting to both people.

5. No, It Should Not Hurt

We hear from parents all the time who have been struggling for weeks before reaching out for help.


They often report that it hurts.  They tried special creams and nipple shields which helped them manage the pain. Now the baby is not gaining well and they are finally reaching out for help.


Why didn’t they ask for help sooner? Because they thought it was normal for breastfeeding to hurt at first.


While there may be some chapping from increased stimulation, if your baby is latching and nursing properly, it will not hurt worse than chapped lips.  This is important because a baby doing it the wrong way may not get enough milk as they get older.


If you have enough pain to shy away from directly latching your baby, it is time to ask for help. Breastfeeding should be both comfortable and comforting to both people, which is why…

6. Falling Asleep Nursing Is Totally Normal

It is normal for both baby and you to fall asleep while nursing.


There is a lot of advice leaving parents worried that this is not healthy, which is simply inaccurate. Avoiding letting a newborn nurse to sleep means limiting feeds and often means less milk transferred in a day.


While establishing a milk supply and good weight gain, cutting short a nursing session (to keep a baby from falling asleep) can undermine these goals.  It also adds an additional element of stress because you’re trying to let breastfeeding feel natural while also fighting a baby’s nature to nurse to sleep.


Fear of falling asleep while nursing is another source of unnecessary stress. This is also totally natural and a good sign that nursing your baby is as comfortable as it should be! Parents frequently worry about falling asleep in their bed while nursing at night and move to a couch or recliner instead.


Unfortunately, people will fall asleep sitting up, too. These are not safe places to sleep with a baby! It’s actually safer and more comfortable to create a safe environment for sleep feeding, since it happens by accident to virtually everyone.


Dr. McKenna, director of the Mother-Baby Behavioral Sleep Laboratory at University of Notre Dame offers research based information and guidelines on safe co-sleeping.


When sleep feeding in the first few weeks can happen safely, breastfeeding is far more sustainable. This comes down to recognizing that…

7. You and Your Baby Need Each Other

When getting a nursing relationship started, we must understand it is a relationship. This is more than just a feeding method. It is a subtle dance between you and your baby.


That intense getting-to-know-each-other phase, where you’re falling in love and discovering yourselves together is important! Taking the time to be really present, physically and mentally, in the first couple weeks, provides an ability to really know your baby, on a deeper level.


The responsiveness this provides helps prevent breastfeeding problems and also develops intuition in knowing when there is a problem or what to do about it.


It’s so, so important to expect to be everything to your baby at first -especially the first 2 weeks.


This might mean planning sleep around baby’s needs, delaying the first bath or circumcision for a bit, and definitely involves a baby that needs a lot of unswaddled holding.


This means leaning in to a physical connection with your baby.  Then breastfeeding well happens much faster and you can move into the “maintenance” stage of your relationship with a solid foundation.  Valuing submitting to your baby’s needs helps when…


8. You Just Won’t Be That Productive

We are a culture of productivity. We’re all about what we accomplish.


Life with a new baby doesn’t provide a lot of that. Your brain won’t work as well as it usually does because of a new biorhythm and hormonal changes that actually affect brain chemistry. This is hard for people who are used to being very functional and astute.


While taking the time to have a “babymoon” period, not a lot else will get done. To feel satisfied holding space for this more vague kind of lifestyle, it is really important to reconsider your values.


Try shifting what is valuable and satisfying to relationships and experiences during this time. If the focus remains, as it often does on “regular life” and what you’re able to accomplish in a day it will be easy to feel lost, confused, or insecure.


This time is about adjusting, building relationships, and just being.


Learning to value what is less measurable, at least in the short term, will make a huge difference in feeling successful. In order to do this, you’ll want to be sure you…

That intense getting-to-know-each-other phase, where you’re falling in love and discovering yourselves together is important! Taking the time to be really present, physically and mentally, in the first couple weeks, provides an ability to really know your baby, on a deeper level.

9. Don’t Take Advice From Just Anywhere

There is a plethora of places to get advice and information about feeding your baby. The internet is a mixed bag.


What worked for your friend, sister, or mother may or may not be what works for you. Some breastfeeding helpers or professionals will be a good fit and some won’t.


Really believing that only you are the expert on your unique situation is important in sorting through all this noise. Good advice will start with the advisor first asking a lot of questions in order to provide individualized ideas.


Take your time, in deciding who or what resources to put your faith in and always be willing to take what does work for you while letting go of what does not.


We definitely wish that parents understood the difference between an expert and a well intentioned social media post. This is important because social media can be so extreme, sometimes, and…


10. Breastfeeding Is Not All Or Nothing

What is “breastfeeding”? This is something that professionals actually have trouble with a lot.


Ultimately, you get to decide what success is, to you. Many people nurse directly while some bottle feed too. They use pumped milk, donor milk, or formula.


Good lactation consultants meet you where you are, in your bigger picture wants and needs. It’s ok to not 100% breastfeed. It’s ok to want to exclusively nurse and not be able to, and to want help mourning that. It’s ok to do different things with different babies.


While planning increases success, many parents envision exclusive breastfeeding and may end up unable to solely breastfeed their child. This may be because of supplementing for a few days early on, because direct feeding isn’t possible, personal preference or simply because of how life works out.


We know that every form of “feeding” is an act of love and nurturing. It all counts!


It’s a really good idea to have a vision for how you want to feed your baby.


Get educated and make a plan for supporting that vision. Understand your options and preferences for professional breastfeeding support. Learn what is normal and what is not, so that you can find ease in your early days with your baby. Finally, be adaptive. Understand that you are in charge of how you nurture your baby.


Lactation consultants want you to know these things because we want you to enjoy your infant feeding relationship.


This is an intense fleeting time filled with many emotions.  Your focus should be on making memories with your precious new baby.

Jessica Altemara is an IBCLC in private practice since 2009. Her goal is to provide excellent, customized, connected care for breastfeeding families in the Triangle region of NC, including Raleigh, Durham, Chapel Hill, Cary, Hillsborough, and surrounding areas. Her practice focuses on meeting the needs of breastfed babies and toddlers who are (or were recently) tongue tied. Her personal and professional experience has led her to work to build an integrative practice utilizing the three pillar approach. Jessica also has a background in education that she utilizes to teach other professionals about optimizing outcomes for families dealing with tongue tie. The original Tongue Tie Doula, she is working to expand care to include a functional medicine mindset and bigger picture care plans. Find Jessica at her practice, Bliss At The Breast.

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