What is an IBCLC?
An IBCLC is an International Board Certified Lactation Consultant. They are frequently RN's (but not necessarily) who have obtained advanced education of over 1000 hours in Lactation. There is also a mandatory 1000 hours of experience prior to taking a rigorous test administered by the Board of Examiners for Lactation Consultants. We are held to the highest standards of care for our patients.
We need to keep current with continuing education, and are re-certified by exam every ten years.
What happens during a visit?
First, a little paperwork to gather your information and discuss your issues and goals. The baby will be examined and weighed, and you will be assessed as well. I will observe your feeding techniques to be able to best assist you having a positive, comfortable nursing experience. You are able to be in the comfort of your own home, and use the positions and props that work best for you. The visits typically last one and a half hours to two hours and have follow up phone support.
Is the visit covered by insurance?
Under the Affordable Care Act, lactation visits are a covered service. However, every insurance company can interpret that differently. I have purchased documentation for you to submit to your insurance company with the proper coding for potential reimbursement, but I am unable to guarantee anything. My recommendation would be to call your insurance company and ask prior to the visit. Some insurances require a referral from your doctor, which should be easily obtained. My fee is accepted at the time of visit. Hopefully, some or all of the cost will be reimbursed.
How do I know if the baby is getting enough milk?
The best way is to look at the baby! Does he/she nurse well at least 8 to 12 times a day, for 10 to 25 minutes per side? Do you feel a gentle tugging in the breast during suckling? Can you hear soft swallows? Do you see milk in the baby's mouth? How about output? At least one wet diaper per day of life ( day one to day six ) and then 6 – 8 per day after that? Stooling at least every other day the first couple of days, and usually several times a day after that? Is the baby content after a feed? And this doesn't mean that they won't be hungry again soon! Their stomach is about the size of their fist, so it fills up quickly, but also empties quickly. They can have cluster feeding days, where they never seem satisfied. Just feed on demand and that should taper off a little. All babies lose weight in the beginning. Around ten percent is considered the maximum acceptable weight loss. Then they will start to gain, and should gain around one half to one ounce per day. Weight should be checked in the first few days, and then at least again in two weeks.
There are so many questions that come up when you bring that new baby home! You should always feel free to call your pediatrician with any concerns. If you are having difficulties with breastfeeding, getting help quickly is the most important thing you can do. Prevention is easier than fixing bigger problems.