What to Expect from an Initial Consultation

A run down of what to expect with common concerns discussed

By Emma Biggar, IBCLC

Last updated 5th December, 2019

Sometimes it can feel a bit daunting having a stranger come to your home and help with something as personal and intimate as breastfeeding. As a new mum you are likely feeling exhausted and possibly a bit overwhelmed and the idea of “entertaining a guest” may only further add to your fatigue or you might be worried about the state of your home (please don’t) or just not sure what to expect.

It can be helpful to have some insight to help allay fears that may be preventing you from reaching out for support. With the right support, the vast majority of breastfeeding challenges can be overcome. I thought I would write something to provide a bit more of an idea of what to expect from an initial consultation.

What to expect from an initial consultation

Starting right at the beginning you would have made a booking. This might have been through the website, by phone, text or email. During your booking process you would have filled out an online form providing details that will help us jump straight into things when I get there and optimise our time together. Beyond this point, no two appointments are ever quite the same.

I will arrive at our pre-booked time with my bag and all the things we will need for the consultation. While we may have arranged a time, that doesn’t mean your baby will conform to our schedule. Sometimes I arrive and baby is super eager to breastfeed. Other times they have just nodded off to sleep and no amount of poking and prodding will disturb their slumber until they are ready. I will work with you and your baby wherever you are at. Usually that means working according to your baby’s moment by moment needs.There are often many things mothers want to discuss and it’s helpful to go through the responses you provided on the online form in detail before we get started so it’s okay if your baby is not ready for a breastfeed right as I get there. In fact, this will actually give us a chance to have a really good discussion and explore the challenges you might be facing and your goals for the session. Of course, if your baby is hungry before I have arrived and you don’t think they can wait a second longer, it is fine to go ahead and breastfeed. I am no stranger to having mothers answering the door while breastfeeding. There’s no need to apologise for not waiting, you are listening and responding to your baby beautifully. Sometimes mothers have even filmed their breastfeeding which has been helpful, especially if the baby does something unusual only some of the time. Wherever the two of you are at is where we will work from. I appreciate the need to be flexible and am happy to accommodate.

There are a few assessments we will go through during the consultation and I will talk you through what I’m doing, often getting you to help by holding your baby in certain positions as needed. We will explore your concerns and tailor an individual plan that is a right fit for you and your baby.

Most of the time parents have a long list of questions and that’s great. There are no silly questions. In fact it can even be helpful if you have written them down beforehand to make sure we don’t miss any. I will make notes throughout the session that then get compiled into a document that you will receive electronically. Contained in this document are my assessment findings, breastfeeding plan and links to online content such as videos and websites that can help further explain or reinforce the things we have discussed. This means you won’t have to hold all the new information in your head, you’ll have notes to refer back to when you need.

Don’t worry if you think of a question after I leave that you wanted to ask. It’s pretty common. Send me a text or email and I can include some information in the document that will provide the answers. You are more than welcome to print off whatever you like from what I send you. You might even want to add the assessment and breastfeeding plan to your baby’s green book or give a copy to you GP, Maternal Child Health Nurse or any other health professional you feel would benefit from being included. This can help keep all your healthcare team on the same page and improve continuity of care. All your information is kept safe and secure. You are in control of who gets access to it.

“But my house is a mess and I don’t have any food or drinks to offer you!”

Don’t worry about the state of your home. I know what it’s like in the early days with a baby. Some days you are kicking goals just by having a shower let alone getting to any of the housework. I have seen homes in all states. From the ones that could pass as a showroom (usually because parents or in-laws are staying), right through to the ones that barely have visible floor. So long as safety is of no concern (which I am yet to come across) then I have no judgements about the state of your home.

While we are on this subject, it can be handy to know that we might use multiple rooms within your home to look at how we can optimise your breastfeeding in different settings, not just on the couch in the lounge. Sometimes we are about to pop into the bedroom only for me to be told to wait behind a closed door while I hear frantic rustling coming from within. It’s okay if it’s messy in there too. I have seen plenty of underwear and other personal items and once again have no judgements about any of this. I am here to help with breastfeeding, I’ll leave the judging of home interiors to those “experts” on TV.

As for food and drinks, in my bag I’ll have my drink bottle. While I love that people are thoughtful enough to offer or even have a drink ready for me, I am happy to keep the focus on you and your needs. I am here to offer you a service so please don’t feel like you need to do or have anything special and certainly don’t worry about creating additional dishes just for me, I really am happy with my water bottle (but thanks for the thought all the same).

“Is it okay that my partner/mother/sister/[insert here] listens in too”

Yes absolutely. The more the merrier. In fact, I encourage your partner and any other support people to be present if it’s an option. They may have different concerns or come up with questions you haven’t thought of or provide extra details that may have slipped your (understandably) tired brain. It can also help if they hear the plan as we make it so that everyone understands what is happening and why. That way you don’t have to try and explain things later. We know that women who have supportive partners are 10 times more likely to breastfeed and this can be a wonderful opportunity to involve them in the process. Sometimes partners need reassurance that we are working on problems, that sometimes it can take some time but are still taking into account what is best for both you and your baby. It’s so common for there to be such conflicting advice which can leave the most confident of parents feeling unsure and full of self doubt. We can discuss everyone’s concerns. We can even discuss ways those around you can help and be involved. After all, your partner, friends and family all want the best for you and baby.

The only exception I tend to make to this is pets. While I love animals, sometimes they can become a little nosey of the stranger in their home or even protective of the new baby. It can be really helpful if they are kept in a separate room or outside. Especially if you think they are likely going to want to join in with the consultation or be bothered by my presence. Plus I very much appreciate not having to remove pet hair from my bag and other belongings as it is something I will need to take with me to the next persons home. I am mindful of not wanting to carry potential allergies from one person's home to the next.

After the consultation.

A day or two following the consultation I will give you a call at a pre-discussed time to follow up on how things have progressed and to see whether any other changes are needed. Most of the time issues are resolved or at the very least improving or heading in the right direction. It is rare that I need to return for additional consultations. This is intentional. I aim to arm you with all the options and information you are likely going to need so that you can take charge and decide what will work best for you and your baby. I will explain the underpinning reasons for suggestions and techniques so that you can experiment with what works for you. I want to leave you feeling confident and empowered to breastfeed. I will continue to be available by phone, text and email for up to two weeks providing you with ongoing support and guidance as you need it. The times where additional visits are needed usually only happens when there are challenges that require long term support. This will be discussed with you and we can make arrangements that will best support you.

Hopefully this answers your questions and provides insight into what to expect. If you have any further questions feel free to contact me. I look forward to hearing from you.

Emma Biggar is an International Board Certified Lactation Consultant (IBCLC), Registered Nurse and mother of three. Emma provides in-home breastfeeding and early parenting support to families in the Eastern and South Eastern suburbs of Melbourne. Click here to read more about the types of services available or here to visit the online booking page. Contact Emma by email here or visit her website or Facebook page.