When Should You See a Lactation Consultant?

See a lactation consultant as soon as feeding hurts, your baby struggles to latch or stay latched, or you are not sure your baby is getting enough milk. The American Academy of Pediatrics says a breastfed newborn should nurse at least 8 to 12 times every 24 hours and have 6 or more wet diapers per day by 5 to 7 days old. If your baby is not meeting those marks, that is a reason to get help the same week.

Cost should rarely be the reason to wait. HealthCare.gov states that health insurance plans must provide breastfeeding support, counseling, and equipment for the duration of breastfeeding, at no cost to you, with grandfathered plans as the exception. This post covers the signs that it is time to call, what a consultant does, the credentials to ask about, how feeding support and chiropractic care can work together, and what Pennsylvania law says about nursing in public.

What Does a Lactation Consultant Do?

A lactation consultant is a trained professional who helps parents and babies with breastfeeding, from the first latch through pumping, supply and weaning.

In a typical visit the consultant watches a full feeding, checks how the baby latches and swallows, looks at positioning, and asks about diapers and weight. You leave with specific changes to try, such as a different hold, a deeper latch technique or a pumping plan.

Most parents start breastfeeding, and far fewer keep going as long as recommended. CDC national data for 2023 show that 86.1% of infants were ever breastfed, 62.8% were still breastfeeding at 6 months, and 29.8% were exclusively breastfed through 6 months. The American Academy of Pediatrics recommends exclusive breastfeeding for approximately 6 months, then continued breastfeeding with other foods for as long as mother and child both want, for 2 years or beyond. Early support is one way families close that gap.

What Are the Signs You Should See a Lactation Consultant?

Call when something feels off, even if you cannot name it. These are the common reasons.

Latch and sucking problems. Our lactation page lists the indicators Dr. Stephanie sees most often:

• Babies who cannot latch firmly

• Babies who can latch and not sustain sucking

• Babies unable to smoothly coordinate sucking, swallowing and breathing

• Babies who can feed in only one position

• Babies who seem dissatisfied when nursing or stay fussy through the day

• Babies who chew and damage the mother's nipples

Pain. Some tenderness in the first days is common. Cracked, blistered or bleeding nipples, or pain that lasts through the whole feeding, means the latch needs attention.

Worry about supply or intake. If you are counting diapers and coming up short, or feedings seem to last all day without a content baby afterward, get the feeding assessed.

A feeding plan that has become complicated. Pumping, supplementing, returning to work, twins or a premature baby all go more smoothly with a plan.

How Do You Know If Your Baby Is Getting Enough Milk?

Diapers, weight and behavior tell you more than the clock does. USDA's WIC Breastfeeding Support calls tracking wet and dirty diapers the best way to tell.

The American Academy of Pediatrics gives these markers for the first week:

• Wet diapers: 6 or more per day, with nearly colorless or pale yellow urine, by 5 to 7 days old

• Stools: blackish and tarry on days 1 and 2, turning greenish to yellow by days 3 and 4, then yellow and loose with small curds, at least 3 to 4 per day, by 5 to 7 days old

• Weight: a loss of no more than 8% to 10% of birth weight in the first few days, before starting to gain again

• Feeds: at least 8 to 12 times every 24 hours

WIC adds signs you can see during a feeding: you can hear or see your baby swallowing, and your baby seems happy afterward, with relaxed hands and feet. The CDC notes that in the first days a baby may want to eat as often as every 1 to 3 hours.

If your baby is missing these markers, call your pediatrician first. Weight and hydration are medical questions, and a lactation visit comes alongside that call, not in place of it.

What Credentials Should a Lactation Consultant Have?

Titles vary, so ask. The best-known credential is the International Board Certified Lactation Consultant, or IBCLC. The certifying commission requires a minimum of 90 hours of lactation-specific education plus 5 hours of communication skills education, 95 hours in total, along with a health sciences background and supervised clinical experience through one of three pathways.

Other titles, such as certified lactation counselor or lactation educator, involve different training. None of that tells you whether a person is a good fit, so ask three things: what their credential is, how many feedings they observe in a visit, and what follow-up looks like.

How Can Lactation Support and Chiropractic Care Work Together?

Feeding is a physical skill for the baby. To latch well, a baby has to open wide, turn the head comfortably to both sides and coordinate the jaw and tongue. A baby who strongly prefers one side, or who feeds well in only one position, is showing a movement preference along with a feeding problem.

That overlap is where a pediatric chiropractor with lactation training can help. In 2023 Dr. Stephanie became a lactation consultant so mothers could get comprehensive support in one location. A visit can look at the feeding itself and at how the baby's neck and jaw are moving. Pediatric adjustments at our office are extremely light. The pressure used is similar to checking the ripeness of a tomato.

Research on chiropractic care for feeding problems is still thin, so we treat it as a complement to feeding support and your pediatrician's care, not a replacement for either. You can read more in our post on whether chiropractic care is safe for babies and toddlers and on the lactation consultant and pediatric chiropractic care pages.

Is Lactation Support Covered by Insurance?

In most cases, yes. HealthCare.gov states that Marketplace plans and all other health insurance plans, except grandfathered plans, must provide breastfeeding support, counseling and equipment for the duration of breastfeeding. Those services may be provided before and after birth.

The same rule covers a breast pump, either a rental or a new one you keep. Your plan may set guidelines on the type of pump and when you receive it, and some plans require pre-authorization from your doctor.

Coverage rules do not guarantee that every consultant is in your plan's network. Call the number on your insurance card and ask which lactation providers are covered and whether you need a referral.

Can You Breastfeed in Public in Pennsylvania?

Yes. Pennsylvania's Freedom to Breastfeed Act, Act 28 of 2007, permits a mother to nurse her child in public and provides that breastfeeding may not be considered a nuisance, indecent exposure, sexual conduct or obscenity.

That matters for feeding on demand. A newborn who eats 8 to 12 times a day will need to eat at the pediatrician's office, at Monroeville Mall and in the parking lot at the grocery store. You are allowed to feed your baby there.

FAQ

How soon after birth should I see a lactation consultant?

As early as you want. Many hospitals offer a visit before discharge. If problems show up at home, book within days, not weeks.

Is breastfeeding supposed to hurt?

Early tenderness is common. Ongoing pain, cracked or bleeding nipples, or pain through the whole feed means the latch should be checked.

How often should a newborn breastfeed?

At least 8 to 12 times every 24 hours, according to the American Academy of Pediatrics.

Can a lactation consultant help with pumping and bottle feeding?

Yes. Pump fit, pumping schedules for work, combining breast and bottle, and building or reducing supply are all part of the job.

Do I need a referral to see a lactation consultant?

It depends on your insurance plan. Some require pre-authorization from your doctor. Ask your plan before the visit.

Can a chiropractor help my baby latch?

A chiropractor can check whether tightness in the neck or jaw is limiting how your baby turns and opens. The evidence is limited, so it works best together with hands-on feeding support. Our articles on what kids gain from chiropractic care and chiropractic care for colic explain how infant visits work.

What if I decide to stop breastfeeding?

That is your decision, and a lactation consultant can help with that too, including how to wean comfortably. Fed, growing and loved is the goal.

Lactation and Family Chiropractic Care in Monroeville, PA

Dr. Stephanie Parrish has focused on prenatal and pediatric care since starting her practice in 2014, became a lactation consultant in 2023, and is a mom herself. Barto Family Chiropractic sees patients from newborns up, which our post on whether a family chiropractor can treat all ages explains in more detail.

If feeding is painful, stressful or not going the way you hoped, bring your baby in and let us watch a feeding with you.

Visit Barto Family Chiropractic or call 412-793-3300 today. Contact us for more information.