What should you expect during a breastfeeding home visit with an International Board Certified Lactation Consultant (IBCLC)?

These days it's pretty rare for a health care professional to offer home visits, and you may be a bit nervous at the thought of it- but I know that the majority of your hours breastfeeding, nursing, or chestfeeding your baby will be spent at your home.  You probably have your favorite spot to sit or lay in to breastfeed, along with your favorite pillows and blankets that you use each day.  It makes perfect sense for me to come to you instead of having you pack everything up and come to me!  Here's some tips on what to do (and not to do) before I arrive on our appointment day, and what to expect while I'm with you.

Before the visit, please: 

-Print and fill out the paperwork that you can access on this site. If you don't get a chance, don't worry!  We can work on them together.- Make a list of all of your questions for me (but remember that text, email, and phone support are included in my fee)

- Expect me to be with you in the room where you spend the most time nursing, whether that be your living room, bedroom, nursery... bathroom... whatever!  I usually always teach side-lying breastfeeding so be prepared to practice in your bedroom or guest room.

- If you have questions about the breast pump you're using, or the bottles you've chosen, or any other gear you're using, try to have them available in case we need to look at them together.

- I have no problem with pets!  However, if you have a pet who is particularly loud or overly friendly when people come over, you may want to plan to have that pet in a different part of the house for our visit.  Also please be aware that some pets may be very territorial over "their" baby when strangers arrive; if a pet seems anxious or upset by my presence in the home, I will ask you to remove the pet from the consult area.

- Older siblings are always welcome to be playing nearby during a consult.  You will want to plan an activity or distraction for them during our time together so that you and I can chat freely.

But please do NOT:

- Don't worry about cleaning your house for my arrival.  Really.  95% of the time one of my tips will be to let go of household chores and spend more time skin-to-skin with your baby anyway.

- Don't make your baby wait to eat until I arrive.  It's nearly impossible to get a hungry, screaming, upset baby to latch!

- Don't change what you've been doing unless I told you to before the visit.  I need to be able to see the whole picture so I can get a better idea of what little tweaks may make a difference in your nursing relationship.

- Don't kick everyone else out of the house.  If you have a spouse, a close friend, or a loved one who is a support to you, I'd love to have them in the room during my visit.  Spouses, grandparents, and sometimes even postpartum doulas have sat in on my consults and told me that they learned a lot about how to support the nursing parent.

- Don't hesitate to tell me if something doesn't feel right.  I will ask you repeatedly during the consult how things are feeling- both physically (pain and comfort wise) and emotionally.  A lot of us have it ingrained to not admit we are hurting or that something sounds like it won't work for us.  I really DO need to know what's working for you so that we can come up the plan that best allows you to meet YOUR nursing goals!

What will happen during the visit?

- I will wash my hands more or less as soon as I walk in the door, and before I touch you or your baby.

- We will sit and talk first, unless baby is hungry and ready to nurse as soon as I walk in the door!  I'll go over your health history, you baby's history, and your challenges and concerns.  We will weigh your baby before a feeding (usually in a dry diaper only).  Then I will ask to observe you breastfeeding, in whatever position and manner you use most. After the breastfeeding session is complete  (or sometimes between sides) we will weigh your baby once more.

- I try to be as physically hands-off as possible.  I will always ask before I touch you, your breasts, or your baby.

- Usually after your baby has eaten, I will wash my hands again, then put on latex-free gloves and do a manual exam of your baby's mouth.- I will look at your nipples before and after baby nurses.  This helps me not only to assess whether you are experiencing nipple damage, but it also gives me a lot of insight into exactly how your nipples is placed in baby's mouth while she or he is breastfeeding.

- You will receive a written care plan for the immediate period at the end of our session and within 24 hours you will receive an emailed care-plan with any supporting literature we may have discussed during our session. You will also receive a superbill to submit to your insurance company.  I will send a written report to your OB, physician, and/or your child's pediatrician about our visit by request.  I will only contact these providers with your written consent.

Adapted with permission from  http://www.rachelobrienibclc.com/what-to-expect.html, Rachel O’Brien, MA, IBCLC