When You Need Help With Breastfeeding

Many people experience breastfeeding challenges. This can happen, even if you have breastfed before, trouble free. Each baby is different, each breastfeeding experience is unique. If you experience breastfeeding challenges, at any point in your breastfeeding journey, there is a lot of help out there.
Probably.
Maybe.
Depends.
Where you live is definitely going to affect how many options you have. The climate towards breastfeeding where you live will also affect your options. People in rural area are going to have less options than people who live in or near cities.

Where you live in the country may affect your options as well. Healthy People, part of the national government, has identified increased breastfeeding rates, and duration, as one of their goals. The CDC reports on these rates for each state every year. States in the south and midwest have lower breastfeeding initiation and duration rates, compared with states in the rest of the country. This doesn’t mean you won’t be able to find help in areas with lower breastfeeding rates. It just means that you may have to look harder.
The different options can be broken down into a few categories. They all have pros and cons. Let’s go over what they are.

Different Options for Breastfeeding Help

Meeting with a lactation consultant (LC)

1. One on one
– If you are experiencing significant problems, this is always going to be the best option. Nothing compares to having an experienced, and qualified, LC having her eyes and hands on the complete problem.

Pros
♣ She can (and should) get your history, not just of the breastfeeding problem, but of other things that might be relevant.
♣ She can do a physical examination. She can look at your breasts, feel and assess your baby’s suck, and tongue, and other things inside his mouth that might be affecting breastfeeding.
♣ She can do weights before and after your baby eats. This is only helpful if she uses a scale calibrated to measure weight to no more than a 2 gm difference.
♣ Most importantly, she can watch a breastfeeding, and assist you, if needed, hands-on.
♣ She can discuss the plan she recommends to address your issue, get your immediate feedback, and make sure it is a plan that you can carry out.
♣ A good LC will do follow up (f/u) with you until your issue is resolved.

* Phone f/u is generally no additional charge.
* F/u at her breastfeeding support group will involve a charge if she charges for the support group
* A f/u consult will usually involve an additional charge

Cons
♣ Cost. Lactation consultants charge for their services (Some hospitals offer consults at no charge if you delivered there, others do charge, and all LC’s in private practice charge).
♣ Many private practice LC’s will not file your insurance for you.
♣ There are different credentials for LC’s. We’ll discuss this further in my next post.
♣ It can be difficult to figure out which LC to go to if you are given different recommendations.

* Hospitals that offer out-patient lactation services
* Your doctor’s office may offer lactation consults (this is a fine option if they have the proper equipment and give you enough time. Just remember, this generates income for the practice and that may be why your dr wants you to see their LC)
*Private LC’s in the community
*LC’s at stores/boutiques

♣ You may not like the LC you chose.

*She may be a good LC, but you just don’t like her style.
*Her advice may just not sound right to you. Although you went to her because she is an expert in this area, you are always responsible for the things you do, even if someone (including your baby’s health care provider) recommends it. It’s best to discuss this right away. It’s frustrating for everyone if things don’t go the way she would have expected because she thinks you followed the plan she gave you, and you never really followed it.
*Be careful about changing if you did like her, just because someone tells you to go to someone else that they liked, or is recommended by your doctor because she is in your dr’s office.

♣ Depending on where you live, getting to an LC may involve significant travel time. Depending on your issue, that may be worth it.

2. Group setting

Pros

♣ Going to a breastfeeding support group usually helps you make those important connections with other moms. They are usually run by an LC. However, this is not the place to bring major problems and expect them to be solved.
♣ Less expensive than a private consult, may even be free.
♣ The LC will be able to help you decide if you need a one-on-one consult to address your issue
♣ Probably will have a scale that you can use to do weekly weights, and possibly even before and after feeding weights
♣ LC should be able to help with position and basic latch technique issues
♣ Opportunity to get questions answered over the course of breastfeeding

Cons

♣  Some LC’s will do a guided discussion which may not be relevant to you at that point in time (for people who like this style of group, this could be a pro)
♣  Not everyone is comfortable in a group setting
♣  If there is a fee, it may get expensive over time, which can discourage some moms from going to something that is an important social outlet for them
♣  If there are a large number of moms and only one LC, she may not be able to give you a lot of time and attention

3. Online consult

Pros
♣ Some LC’s offer Skype or Facetime consults. This is something I will be doing in the very near future. Keep an eye out for “Consults” to be added to the menu.
♣ Having an experienced LC observe a breastfeeding can be enormously helpful
♣ The LC can get a through history
♣ It allows both you and the LC to get all of your questions answered
♣ It is a good option when there are no in-person, one-on-one, options available
♣ The cost should include f/u by phone or email
♣ Depending on the flexibility of the LC, it can allow for flexibility in terms of the times this can be done
Cons
♣ There are obviously limitations to a consult like this. There can be eyes on, but no hands on. Make sure the LC has some kind of screening tool to determine if the help you are looking for would be within the scope of this kind of consult.
♣ This kind of consult probably will not be covered by your insurance
♣ An additional consult will be an additional fee.

4. Phone help with a lactation consultant

Pros
♣ Usually free, although some do charge for it
♣ It is always helpful to have that direct conversation
Cons
♣ This is usually not going to be in depth, and be respectful of the LC and if she recommends a one-on-one consult, don’t try to get her to give you the same amount of time on the phone.

Other ways to get help and advice from an LC

1.Email or online question and answer forum with a lactation consultant

Pros
♣Usually free
♣Flexibility in terms of when you send your question and look at the answer
Cons
♣ Only basic questions and issues can be addressed
♣ You don’t always know who is giving the advice on the other end
♣  Only basic questions and issues can be addressed

2.Reputable websites and blogs (like this one!)

Pros
♣ Free
♣ Can look at variety of sites and see if information is consistent or conflicting
♣ Can find sites that you trust and return to again and again
♣ Can be looked at whenever your time allows
Cons
♣ General information
♣ Variety of opinions can be overwhelming
♣ You may not know what the reputation of the person posting is
♣ Conflicting information

3. Realizing the person who is putting gas in her car next to you is an LC because you ask her about the breastfeeding bumper sticker on her car, or seeing the LC who facilitates the hospitals breastfeeding group is in line behind you at the grocery store. Kidding. Sort of. Both of these things happened to me at least once. There was also the time the college student saw my bumper sticker and wanted to know what it was about, and then wanted to know what difference it made. But I considered educating him a public service. His future children will thank me.

Mother to mother help

1. Official

Pros
♣ As mentioned before, that connection with other moms is so important
♣ Groups like La Leche League provide their leaders with training
♣ May be free
♣ Sometimes this is all there is

Cons
♣ Limitations in terms of how many different issues this person has dealt with
♣ Some more complex issues require more formal training and background, and there is always the chance that the person providing help will think she has greater capabilities to solve problems than she does
♣ She may not refer you to a professional when she should

2. Social, including Social Media

Pros
♣ Free
♣ Someone who has gone through what you have
Cons
♣ You have no idea if this person knows what they are talking about
♣ Just because something worked for one person, doesn’t mean that it is appropriate for your situation
♣ Conflicting advice, which can be overwhelming (sometimes I get overwhelmed by all the answers moms get on some of the Mom Facebook groups I belong to)
♣ Incorrect information. I have had to gently correct some of the things moms have said in the groups I facilitate.

Books, magazines, the internet 

There is so much out there, that I don’t even know where to begin on the pros and cons here. For everything recommended, you can be sure there is something out there with an opposing viewpoint. My biggest pieces of advice for this category?
• Don’t read too much.
• Remember, ultimately, you are the one responsible for the decisions you make for your situation, and you always “drive the bus.” Listen to that wise inner voice. Come to think of it, I guess that’s going to be true for most things,

I am sure I haven’t included absolutely every option, but these are the ones that are most readily available.

One last thought:
Many moms experience breastfeeding challenges at some point in their breastfeeding journey.
While all the options and advice can get overwhelming, let these things guide you:
• There is help out there!
• Breastfeeding is not an all or nothing deal.
• There can be more than one way to handle these challenges.
• You always drive the bus, are responsible for the decisions you make.