You’ve had your baby and you’re having breastfeeding issues. You’ve decided it’s time to seek professional help from an International Board Certified Lactation Consultant (IBCLC). However, you’re a bit hesitant as to what you can expect from such a visit. Will you have to be topless? Will you need to prove your milk is worthy? And exactly what is this IBCLC going to be able to assess from seeing you and your baby anyway? Fear not! I’m going to outline for you what you can anticipate for your visit with the IBCLCs of Baltimore-based The Rumina Center.
Ample Time
Firstly (and thankfully), do not expect this to mirror a rushed doctor’s visit, where you may get 15-minutes of time with the healthcare professional you just waited 45 minutes to see. Katy and her team are very passionate about helping you meet your breastfeeding goals and they spend the necessary time to assist you with whatever hurdles you may be encountering. You should plan for this initial consult to last about 1.5 hours.
Health History and Feeding Concerns
In that timespan, the two of you will review the intake form you filled out prior to this visit. Yours and baby’s health history will be covered. There will also be a variety of questions about your feeding challenges so that the IBCLC gets a full and clear grasp on your concerns.
Hands-on Evaluation
It may surprise you to know that an IBCLC does far more than simply watch you feed your baby. They are well-trained in mouth/feeding function and able to assess physical barriers to successful breastfeeding. So, in this portion of the visit, the gloves will go on and your IBCLC will do an oral exam; checking to see how your baby is moving their tongue, how the mouth is functioning in general, and looking/feeling for potential tethered oral tissue, more commonly known as lip and tongue tie.
After checking for oral function, baby’s body tension will be evaluated. For instance, does baby favor one side to the other, does he have difficulty turning his head evenly from side-to-side, do arms move freely, do arms cross appropriately at the chest and meet at the elbows in the center or is baby unable to do that comfortably? All of these physical signals of body-tension help your IBCLC know what the root cause of feeding difficulties may be and they provide insight into what interventions will be most helpful. In case you may be wondering, none of the physical exam is performed roughly or in an invasive manner. Your IBCLC will always treat your baby gently and with loving care.
Feeding-Observation
Before you latch baby on for your IBCLC to observe a feeding, baby will be weighed. This is referred to as a pre-feed weigh-in and will help determine the volume of milk being transferred in a given feeding. At this point you will settle in to nurse baby and the IBCLC will watch and make suggestions. She will assist in altering latch-positioning if need-be, try different breastfeeding aids if the situation seems to call for that, and make verbal suggestions and observations regarding how the nursing session unfolds. Once baby has completed the feeding, a post-feed-weight will be taken so your IBCLC can determine the amount of milk that was consumed in that feeding.
Next Steps
Based on the transfer-rate that is noted, baby’s overall weight-gain trend, and your personal breastfeeding goals, you and your IBCLC will discuss and develop a plan to help you meet those goals. Exercises may be given to help baby with anything that was noted during the physical exam, along with tips and tricks for optimal latching. If necessary, referrals to other providers (i.e. our pediatric physical therapists, specialists, pediatric dentists) will be given and you will be informed as to how said provider could further improve your nursing situation.
Typically you can expect a follow up appointment in approximately a week to see how the plan is going and what improvements have taken place.
Communication is Key
Please do not hesitate to reach out. Your IBCLC wants to assist you and answer your questions to help ease and improve your breastfeeding experience. You are not a burden to her if you need to clarify instructions or ask for a reiteration of previously-discussed suggestions, or if something new arises. Your IBCLC understands how stressful your situation may be and she is ready, willing, and well-prepared to help you!
