How to Get the Most Out of Your Prenatal Lactation Consultation
Jen Mueller, IBCLC
A prenatal lactation consultation is one of the more underused resources available to expecting families, which is a shame, because you could be missing out on an ideally timed resource. You have time to absorb information, ask questions without a newborn in your arms, and make a plan before you need one.
But there's a real difference between a lactation consultation that covers everything from scratch and one that starts from a foundation you've already built. The latter goes further, gets more specific, and is almost always more useful. A little preparation makes that possible.
Here's what to do before you come in.
Take a prenatal breastfeeding class first
This is the most important step, and it comes before everything else on this list.
A prenatal consultation is not a breastfeeding class. When used best, it’s a chance to apply what you've already learned to your specific situation: your health history, your circumstances, your questions. When that foundation isn't there, the appointment has to cover basics that would have been better absorbed in a class setting, and there's less room for the personalized conversation that makes a consultation really valuable.
The Breastfeeding Center’s (BCGW) Breastfeeding and Pumping Basics class covers what newborn feeding actually looks like in the first days, how milk supply works, how to recognize that things are going well, and what to watch for when they aren't. Take it before your consultation if you can.
If you want to go a little deeper before you come in or aren’t able to fit in a class, here are a few books we recommend:
Breastfeeding Made Simple by Nancy Mohrbacher and Kathleen Kendall-Tackett is the most practical and evidence-based general guide available. If you plan to return to work within the first 3 - 4 months postpartum, Breastfeeding Made Simple has a companion volume: Breastfeeding Made Simple covers the full arc, while Breastfeeding and Working Made Simple goes deep on pumping, supply, and logistics. Either or both are worth having.
The Art of Breastfeeding, published by La Leche League International, has been the foundational breastfeeding reference for generations of parents. It's thorough, warm, and reliable.
Let's Talk About Feeding Your Baby by Amy Brown is especially worth reading if you're still deciding between breastfeeding and formula feeding, or if you expect to do a mix. It's honest, non-prescriptive, and remains useful throughout the introduction of solid foods.
The books worth reading on breastfeeding and infant feeding are written by people who have spent careers doing it. That means International Board Certified Lactation Consultants (IBCLCs), pediatricians, and researchers with deep clinical backgrounds. That's worth saying because many popular baby books aren't. Parenting advice from economists, journalists, and social scientists can be interesting, but infant physiology and feeding aren't their primary areas of expertise.
For a visual introduction before your baby arrives, two video resources are consistently excellent:
naturalbreastfeeding.com - clear, well-produced video guidance on positioning and latch
Global Health Media - a free library of short breastfeeding videos used by lactation professionals worldwide
On the BCGW blog, two posts are good preparation reading: Breastfeeding Myths: The Early Weeks addresses common misunderstandings about newborn feeding behavior, and How To Know If My Baby Is Getting Enough Milk covers the signs that feeding is going well and what warrants a closer look.
Another great resource for before or after baby arrives is KellyMom.com, a well-sourced, dependable website written by a lactation consultant.
Bring your pump or your short list
If you already have your breast pump, bring it to your appointment. Not because we'll spend the whole session on it, but we may discuss its settings and likely flange fit.
Most standard breast pump packages include a 24mm flange. That size fits some parents but not most. If you are in the majority, it's much easier to sort it out before your baby arrives than in the first days postpartum, when you may need the pump quickly.
If you haven't ordered a pump yet, bring a short list of the two or three you're considering. Most major insurance plans cover a breast pump. If you haven't looked into your coverage yet, that's worth doing before the appointment. We can talk through the options on your list, what to look for, and what to order. We also have a display of select breast pumps in our shop and rent multi-user pumps, if needed.
Think through your situation
A prenatal consultation is most useful when it's specific. Before you come in, it's worth thinking through a few things:
Your health history. Certain medical factors, such as breast surgery, PMOS, thyroid conditions, a history of infertility, or difficulty with milk supply in a previous pregnancy, can affect how breastfeeding starts. These aren't reasons to expect problems, but they're worth discussing so we can think through what to watch for and what your first week's plan should account for.
Your birth plan. A planned cesarean, an induction, or an anticipated NICU stay all have implications for early feeding. If any of these are on the table, bring them.
Your practical circumstances. When are you returning to work? Will you be nursing exclusively, or is pumping from the start part of the plan? Do you have support at home in the first weeks? The more specific we can get about your situation, the more useful the first-week plan we build together will be.
Your questions. Write them down before you come in. The ones you think of at 2 a.m. during your third trimester are usually the good ones.
When to schedule
The third trimester—roughly 34 to 38 weeks—is the right window to complete your prenatal consultation. Early enough that you have time to act on anything we discuss; late enough that the conversation is specific and relevant to where you actually are.
If you're earlier in your pregnancy and want to get a sense of what a prenatal consultation covers, feel free to reach out. There's no wrong time to start thinking about this.
Jen Mueller is an International Board Certified Lactation Consultant practicing at the Breastfeeding Center of Greater Washington. When she’s not at the center, you might find her teaching children’s and family yoga or infant massage or otherwise working with new parents at Breathing Space on Capitol Hill or traveling with her teenage daughter and husband. She offers prenatal consultations, postpartum lactation support, pump consultations, weaning support, and flange fittings.