Frequently asked questions

Why might a mother need a lactation consultant?
What is a lactation consultant?
What causes a low milk supply?
Is it normal to have trouble breastfeeding?
Is it expensive to breastfeed?
Is insurance accepted?
What is induced lactation?
Can a nursing mother consume alcohol?
I am taking a prescription medication. Is it still ok to breastfeed?
What is relactation?
What is breast engorgement?
How is engorgement treated?
What causes sore nipples?
Does every nursing mother need a breast pump?
How can grandparents help the breastfeeding mother?
What is a late preterm infant?
Do I need extra fluids when breastfeeding?
Do I need to follow a special diet while breastfeeding
What is Kangaroo care?
Will the baby's father feel left out if I breastfeed?

Why might a mother need a lactation consultant? (back to top)

The birth of a child is a wonderful and joyous occasion, welcomed by parents and extended family as well. But sometimes, despite all the joy and celebrating, your baby’s birth can also bring unanticipated emotions and anxieties.

An internationally Board Certified Lactation Consultant is educated to assist a mother, infant and her family with the possible challenges of breastfeeding through education , hands on support and emotional support. Your breast milk is a uniquely perfect for your baby. Providing breast milk for your infant is a gift only a you can give. An IBCLC can help you provide that gift.

Why might a mother need a lactation consultant?What is a lactation consultant? (back to top)

A Lactation Consultant is a health care provider with advanced education and training in the field of human lactation and breastfeeding. Health care professionals who may choose to become board certified in lactation consulting include physicians, registered nurses, occupational therapists, speech therapists, and dieticians. There are certified lactation consultants with an educational, business, or legal background as well.

A lactation consultant can provide assistance to a nursing mother in many situations such as latch difficulties, nursing multiples, nursing premature and late term infants, induced lactation for adoptive mothers, nursing infants with down’s syndrome, low milk supply, sore nipples, assistance with treatment of mastitis and plugged ducts and infants with poor weight gain. A board certified lactation consultant educates families about breastfeeding and offers support. A lactation consultant also trains hospital staff in breastfeeding management, serves as a resource for hospital staff, and refers mothers to other health care professionals as necessary.

A board certified lactation consultant will have the initials IBCLC behind their name. The USLCA - United States Lactation Consultant Association - is the presiding organization in the United States of America and the International Lactation Consultant Association is the professional organization for lactation consultants internationally.

Pocket Guide for Counseling the Nursing Mother, pgs 10-11, Debbie Shinskie and Judith Lauwers. Jones and Bartett publishers Boston 2002

What causes a low milk supply? (back to top)

According to Lisa Marasco, IBCLC and Diana West, IBCLC, MA., IBCLC, authors of The Breastfeeding Mother’s Guide to Making More Milk, despite the fact that it is rare for mammals not to make enough milk for their off spring, the fact remains that some human mothers do not make enough milk. A low milk supply can have a primary and or secondary cause. A primary cause can be a medical condition present in the mother such as diabetes, infertility, history of breast surgery or insufficient mammary tissue to name a few.  A secondary cause occurs when a mother begins the breastfeeding process with a full supply of milk and then something happens to cause a decrease in her supply. Some secondary causes include but are not limited to: poor latch, infrequent feeds, medications taken by the mother, tongue tie in the infant, suck problems in the infant, premature or late preterm infants or a medical condition in the infant.

A board certified lactation consultant is trained to assess and evaluate the mother, infant and the breastfeeding session to determine the root cause of a low milk supply and help the mother devise a plan to increase her supply. Many times there is an easy solution such as adjusting an infant’s latch or increasing feeding frequency or pumping. Other problems can take more time to correct and may require the referral to another health care professional such as a physician or occupational therapist.  If a mother suspects she has a low supply, she should seek the help of certified lactation consultant in her area for assistance. The sooner treatment is started, the better the chances of improving her supply.

Is it normal to have trouble breastfeeding? (back to top)
Despite what most people think, breastfeeding is not a natural skill that all babies do well with from the beginning. For some mothers and babies, it is a skill that must be practiced. Some babies will latch immediately after birth and others because of situations such as a difficult birth or anatomical problems, will need more patience and assistance. Factors beyond a mother’s control such a preterm birth or health problems in a mother can effect breastfeeding.
Is it expensive to breastfeed? (back to top)

Breastfeeding can save a family thousands of dollars a year. It is estimated that breastfeeding can cost between zero to $400 the first year; while formula feeding can cost over $2,800!

Formula Brands


Per Can

Cost per

Cost per

Enfamil Lipil Powdered

94 oz




Enfamil Lipil Concentrated

26 oz




Enfamil Lipil Ready Feed

32 oz




Similac Adv. Powdered

115 oz




Similac Adv. Concentrated

26 oz




Similac Adv. Ready Feed

32 oz




Isomil Adv. Powdered

94 oz




Isomil Adv. Concentrated

26 oz




Prosobee Lipil Powdered

94 oz




Prosobee Lipil Concentrated

26 oz




Nutramigen-Lipil Powder

115 oz




Nutramigen-Lipil Concentrated

26 oz




Alimentum-Adv. Ready Feed

32 oz




Progestimil Power

112 oz




Lacto-free Lipil Concentrated

26 oz




Formula for Profit: How Marketing Breastmilk Substitutes Undermines the Health of Babies. From the Florida Breastfeeding Coalition, Inc.


Is insurance accepted? (back to top)

You will be provided with an insurance super bill after your initial consultation. This can be submitted to your insurance company for reimbursement. Please consultant your health insurance provider for individual reimbursement rates and regulations. Orange County Breastfeeding Consultants does not bill medical insurance companies directly.

What is induced lactation? (back to top)

Induced lactation is the process of inducing lactation in a woman who has never had a baby such as an adoptive mother or a woman who has biological children who now wants to nurse an adoptive child. Induced lactation attempts to increase proliferation of ducts and growth of the mammary by artificial means. By pumping, hand expression or the nursing infant, stimulation of the hormones prolactin and oxytocin is accomplished to stimulate milk production and through administration of exogenous hormones, estrogen and progesterone, the breasts are readied to produce milk. Many mothers have been reported to produce breast milk through induced lactation although reports are anecdotal. Galactagogues (a drug or herb that can increase breast milk) are also used in induced lactation . Some women choose to use galactagogues rather than hormones due potential side effects of hormones. Women who have had blood clots, hypertension, and history of stroke or cardiovascular disease should not take hormones but should use only galactagogues instead. If a mother decides to induce lactation, she will be working closely with her physician and lactation consultant. There is a regular protocol that is started at least 6 months before a baby’s arrival, as in the case of a surrogacy and an accelerated protocol is suitable for adoptive mothers who only have 2-6 months to plan. There is also a menopausal protocol for women who reached menopause naturally or who have had their ovaries surgically removed. Pumping with a fully automated double pump 8 times a day is involved in all three protocols. Many times, women who follow the regular protocol are able to meet most of their babies’ needs. Most women on the accelerated and menopausal protocol will also need to also supplement. The protocols attempt to mimic what happens in a woman’s body before and after pregnancy. If a woman’s physician is unfamiliar with the protocols, she may obtain a copy of the protocols from her lactation consultant and consult with her physician about it.

Huggins, Kathleen.,(2005). The Nursing Mother’s Companion. Special mothers, Special Babies (pp.87-94). Boston, Massachusetts: The Harvard Common press

Riordan, Jan.,(2005). Breastfeeding and Human Lactation. Women’s Health and Breastfeeding (pp.467-470). Boston: Jones and Bartlett Publishers.

Can a nursing mother consume alcohol? (back to top)

The American Academy of Pediatrics Committee on Drugs considers an occasional alcoholic drink compatible with breastfeeding. The key word is occasional. It takes 2-3 hours for a 120 lb woman to clear 1 glass of wine from her body. It can take 13 hours for 120lb woman to clear one high alcohol drink. If a mother wishes to have a glass of wine or beer, she should wait 2-3 hours before nursing. The more alcohol that is consumed, the longer it takes to be eliminated. Parents must keep in mind that moderate alcohol consumption (more than 1 glass a day), can inhibit let down, affect infant motor development, cause slow weight gain and inhibit milk intake. Some authors feel that a nursing mother should limit her alcohol intake to 1-2 drinks a week. One drink is 8oz of wine, 24 ounces of beer or 2 ½ ounces of alcohol. One must also remember that too much alcohol can also impair a mother’s ability to care for her infant.

Mohrbacher, N.,& Stock, J.(2003). La Leche league International. The breastfeeding Answer Book. Substances of Concern (pp. 597-598). Schaumburg,Il: La Leche League International Spangler, A.(2000) Breastfeeding A Parent’s Guide. Eating for two (p134). Abby Drue Inc.

I am taking prescription medication. Is it still OK to breastfeed? (back to top)

Most drugs are compatible with breastfeeding but some are not. It is always wise to check with your pediatrician and lactation consultant before continuing to breastfeed on either a prescription or nonprescription drug. Many times if a medication is not safe for breastfeeding it can be changed to one that is.

What is relactation? (back to top)

Relactation is when a mother may have stopped nursing an infant, perhaps because of a medical condition, and now wants to breastfeed again. By taking a drug that stimulates milk production and using a fully automated breast pump, many mothers can produce a full or partial supply of milk. A baby will need supplemental feedings until a full milk production has been established. The longer it has been since breastfeeding was stopped, the longer it will take to reestablish the supply.

What is breast engorgement? (back to top)

At 3 - 6 days postpartum the breasts may become temporally swollen and uncomfortable. They may feel hard and very heavy. This is caused by the start of the milk production and a rush of blood and lymph fluid to the breasts to aid in the milk production. This is called engorgement and it typically lasts about 12 to 48 hours. During this period, the infant may have trouble latching because the areola becomes swollen or the milk may not flow well. Engorgement is worsened by infrequent nursing or pumping.

How is engorgement treated? (back to top)

Make sure the infant is latched and positioned properly at the breast. Allow unrestricted nursing in the early days with a goal of 8-12 feedings in 24 hours to remove incoming milk. If breasts still become engorged, a mother may apply cold packs covered by a thin kitchen towel to the breasts in between feeds. Frozen bags of peas or corn work well or fill a zip lock bag with crushed ice. The cold pack can be applied for 20 minutes but never directly on the breast. For severely engorged breasts, apply the cold compresses for twenty minutes on and twenty minutes off through out the day. Some authors recommend a warm shower or soaking the breasts in a pan of warm water, but this should only be done if the milk is flowing freely as heat can cause inflammation to increase and a worsening of the engorgement to occur. Gently massaging the breasts in a circular motion using the flat part of the hand while feeding, will help the milk to flow. If the breasts are still hard and uncomfortable after the feed, hand express milk or use a breast pump until the breasts feel more comfortable. Only a small amount will be pumped at first because most of the fullness is caused by blood and fluids that cannot be removed. Over pumping is discouraged because it can cause chronic overproduction of milk. Pumping a few minutes prior to latching the infant may soften the areola and assist in obtaining a proper latch. An infant may need to be put to the breast every 1 to 2 hours during the engorgement period. Some mothers find taking a pain reliever such as Tylenol or ibuprofen helpful during this period. Severe engorgement requires immediate attention as unrelieved engorgement can cause the milk production to stop. Engorgement can also lead to a plugged duct or mastitis. It is helpful to remember that engorgement is a temporary condition lasting only 48 hours.

Huggins,K.(2005). The Nursing mother’s Companion. (pp48-49) .Boston: Harvard Press Spangler,A.(2000). Breastfeeding A Parents Guide (pp.67-69). Abby Drue, Inc

What causes sore nipples? (back to top)

The most frequent cause of sore nipples is poor latch and positioning. Other causes include but are not limited to: yeast infection of the nipple, tongue tie or too high a setting on a breast pump. A certified lactation consultant will observe a feeding, perform a breast assessment of the mother and an oral exam of the infant to determine the cause of sore nipples and determine a solution.

Does every nursing mother need a breast pump? (back to top)

The answer is no. If a mother knows for sure she is returning to work within 6 weeks, she may want to purchase one before delivery or register for one. If a mother is not returning to work and just wants to pump occasionally, for example a date night with her husband, a high quality hand pump will do. Your lactation consultant can guide you as to which pump is the right one to fit your needs.

grandparentsHow can grandparents help the breastfeeding mother? (back to top)

Grandparents can be a world of help to the parents who have just experienced the birth of their child. Breastfeeding mothers will benefit from nutritious meals and maybe a little help with toddlers and preschoolers who maybe at home. Make sure she always has a beverage while nursing and offer to watch the baby while she naps. This is your time to bond with your precious grandchild!

It is important for grandmothers who may have nursed their children not to focus on difficulties they may have had while nursing. Breastfeeding mothers today have access to more resources to help them such as lactation consultants, support groups and boutiques that carry the latest items to assist the nursing mother. There are now electric breast pumps for working moms that may not have been available when you breastfed.

Don’t deflate her confidence by suggesting that she may not have enough milk and pressure her to give formula.  If there are concerns, gently suggest that she contact a lactation consultant for assistance.  You can help her provide the most precious gift that only a mother can give next to life itself.

What is a late preterm infant? (back to top)

A late preterm infant is a baby born between 34- 36-6/7s weeks. These infants are at an increased risk for hypoglycemia, jaundice, temperature instability, respiratory distress and poor feeding. Because these babies do not have full development of their sucking pads, have lower energy stores and have an immature neurological system they may not breastfeed as well as a 39 or 40 week gestational infant. Most of the time mothers must give supplemental pumped breast milk to make sure their infants consume enough calories. Mothers will also need to pump with a high quality electric pump to stimulate and empty her breasts as her infant will not be able to do so sufficiently until they reach approximately 39-40 weeks gestation. Pumping will insure that a mother will have a good supply of breast milk that her late preterm infant especially needs. Your lactation consultant can help you with a pumping regimen and help you monitor your infant’s progress at the breast.

Walker, M (2009) Clinics in Human Lactation Breastfeeding the Late Preterm Infant (pp 1-18) Amarillo, Texas: Hale Publishing

Do I need extra fluids when breastfeeding? (back to top)

A nursing mom should drink to thirst throughout the day and aim for 8 ounces of a decaffeinated beverage at each nursing session. I recommend moms start sipping fluids a few minutes prior to putting their baby to breast. Over consumption of fluids will not increase a milk supply and may decrease it.

Do I need to follow a special diet while breastfeeding? (back to top)

No! Most women just need to consume the same amount of calories as before pregnancy unless they are extremely under weight, are a teenager or have given birth to multiples. Some babies get a little fussy with chocolate, milk products, caffeine, nuts, broccoli, beans, onions or citrus foods. If your baby seems to be bothered by any of these foods, you will want to limit them but you do not have to automatically take them out of your diet. Consume small amounts of them in the beginning and see how the baby reacts.

What is Kangaroo Care? (back to top)

kangarooKangaroo care is when a mother or father puts their infant or infants (in the case of multiples), who is wearing only a diaper, directly on their bare chest for skin to skin contact. A blanket is then placed over both of them. Kangaroo care should been done immediately after birth and should be continued in the early weeks at home. Skin to skin contact is especially important for babies in the neonatal intensive care unit once the baby is stable. It will help a preemie regulate his or her body temperature, and decrease heart and respiratory rates.  Studies show that skin to skin contact makes an infant feel more secure and enhances brain development. Your preemie will have better weight gain with skin to skin and you will bond and feel more attached to him or her sooner. Research has proven that even infants on ventilators or very low birth weight infants benefit from kangaroo care. Skin to skin contact enhances breastfeeding as the baby smells his mother and associates that smell with breastfeeding. It also helps to increase a mother’s prolactin levels.  If the hospital staff where you deliver does not offer kangaroo care, ask for it. Most hospitals encourage kangaroo care.

Walker, M. (2009) Clinics in Human Lactation–Breastfeeding the Late Preterm Infant (pp 49-51). Amarillo, Texas: Hale Publishing

Will the baby's father feel left out if I breastfeed? (back to top)

LovingDaddyNo! There are so many ways a new father can be involved with breastfeeding. In the early weeks, many new dads will get the baby ready for nursing by changing the diaper and bringing the baby to their partner. Dads can do the burping and help to make sure mom has adequate liquids and nutrition. Many dads enjoy giving the baby a bath as their special time with their newborn. Mothers need support during the rough times and who better to do that than their partner. Dads will have a chance to feed their infants pumped breast milk when mom has to be away. New fathers have an important role in making sure their infants have the most perfect food, which is breast milk.

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Recommended reading

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