Question 1

Are you vaccinated?

Accepted Answer

Yes! I am fully vaccinated and boosted against coronavirus, and I am fully immunized and up to date on all vaccinations per CDC guidance.(https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html)

Question 2

(Why) Do I need a lactation consultant?

Accepted Answer

Breastfeeding is a very personal experience and reasons for seeking assistance vary widely. Some hire a specialist when they encounter challenges, others just want a little reassurance, and almost everyone has a lot of questions! An IBCLC can guide you through ups and downs as your breastfeeding experience evolves. Most importantly, no matter what path you choose, a good IBCLC will support you unconditionally.

Question 3

How much is a consultation? Do you offer in-home and virtual consultations?

Accepted Answer

Consultations are $250 and follow-up visits are $150. There is no cost for consultations if I am in-network with your insurance company.

Question 4

Is one visit usually enough?

Accepted Answer

It would be great if all clients could be one and done, but the reality is that breastfeeding issues can be complex and often take time. Your visit(s) will never be rushed as we go over things in detail and create a plan of care that works for you. After the visit, you can contact me any time with questions. Because your feedback is essential in moving forward, we will follow-up by phone in 1-7 days depending on the issue(s), make necessary changes, and schedule a follow-up visit, if needed. If I am in-network with your insurance company you automatically get six visits, should you want them.

Question 5

Do you take insurance? What payment methods do you accept? Can I use my FSA/HSA card to pay you?

Accepted Answer

Yes, I am in-network with some insurance companies. If you have health insurance, you can navigate the following forms to confirm coverage: AETNA,(https://secure.gethealthie.com/users/sign_up/clients?provider_id=7553040) CIGNA,(https://portal.wildflowerhealth.net/affiliate-care/e149639) UNITED HEALTHCARE,(https://secure.gethealthie.com/users/sign_up/clients?provider_id=7553040) and ALL OTHER PLANS.(https://go.lactationnetwork.com/LoraThomas) If you are paying out-of-pocket, you can pay with Venmo, cash, check, credit card, HSA& FSA cards, Apple Pay, Google Pay, Zelle, and PayPal. You will be provided with an itemized receipt (called a superbill) upon request.

Question 6

How do I prepare for a consultation? What happens during the visit?

Accepted Answer

To prepare for a consultation you don't need to do anything at all except be present. It does not matter what condition you, your baby, or your home is in. And I love your pets, especially the dog ones.

A typical consultation will include a brief health history and discussion about your baby's delivery and feeding thus far. We can weigh your baby on my hospital grade scale before you breastfeed, then weigh the baby after the feeding to gauge intake. We’ll do a deep dive into whatever issues you’re experiencing. Sometimes a pumping session is necessary. I'll give you a realistic plan of care, taking into consideration the nuances of your baby, your needs and goals, and your family's well-being. Instructions for follow-up are provided. Initial visits are usually 1.5 hours.

Question 7

What does IBCLC mean? Are all lactation consultants IBCLCs? Does it matter?

Accepted Answer

IBCLC stands for international board-certified lactation consultant. An IBCLC is the highest-level breastfeeding professional with the most education and hands-on experience you can find anywhere in the world. The title lactation consultant is not used by IBCLCs alone. There are other certifications like CBE, CBS, CLC, CLE, etc. which are limited in their scope of practice. IBCLCs are carefully trained to detect and treat complex breastfeeding issues. Non-IBCLC lactation consultant certifications are limited to helping with basics such as positioning and latch. It is an important distinction to make because in many places you can hire an IBCLC for the same price you would pay for a someone with a lesser credential.

Question 8

Are you like the nurses and lactation consultants in the hospital?

Accepted Answer

A visit with me is entirely different and I will help you sort through the multitude of conflicting information you have received.

Question 9

What is your style?

Accepted Answer

My approach is mellow, and I allow us to take our time. Though I consider infant feeding issues very serious, I try to keep things light because you deserve to work on breastfeeding in a relaxing environment. I have zero interest in judging your decisions or pressuring you into a care plan that does not suit you. My goal is to create a safe space for you to be candid and open. You have my unconditional support no matter what path your breastfeeding journey takes.

Question 10

I'm pregnant. Should we meet before the baby comes? Do I need to book in advance?

Accepted Answer

Congratulations on your pregnancy! I'm so glad you landed here. Sure! It's always great to meet before the baby arrives so you can get all your questions answered beforehand. When I am in-network for your insurance, prenatal visits are covered.

Question 11

I had a breast reduction. Will I be able to breastfeed?

Accepted Answer

You will be happy to hear that I see great outcomes with my clients who have had breast reductions. Success with breastfeeding after reduction (BFAR), heart surgery, implants and removed implants depends on how much time has elapsed and the kind of surgery. Professional assistance with breastfeeding management from day one is prudent.

Question 12

Can I breastfeed with implants/breast enhancements?

Accepted Answer

Most people can, and I rarely see problems. Success with breastfeeding with implants can depend on how much time has elapsed and the kind of surgery. Professional assistance with breastfeeding management from day one is prudent.

Question 13

Can I breastfeed with nipple piercings?

Accepted Answer

Yes, you can. The publication Healthline has a great article (https://www.healthline.com/health/parenting/breast-feeding/does-nipple-piercing-affect-breastfeeding)on this subject.

Question 14

Is breastfeeding supposed to hurt? How long is breastfeeding painful?

Accepted Answer

No! Your sister, mom, friend, coworker, employee, doctor, doula, accountant, barista, and people you follow on Instagram were well intentioned but incorrect—breastfeeding is not supposed to hurt. If you have pain associated with breastfeeding for more than a day or two get help. Do not delay.

Question 15

How do I know my baby is getting enough milk?

Accepted Answer

In a typical situation we do not need to know how much a breastfed baby gets we just need to the baby gets enough, and we have quantifiable measures: audible swallowing, diaper count, and weight gain. If you have more in-depth questions, please contact me.

Question 16

Can you help with tongue ties, lip ties, oral restrictions, etc?

Accepted Answer

If you do not know what tongue ties are, you can learn more here.(https://milkmatters.org.uk/2011/04/15/hidden-cause-feeding-problems/) My experience with ties goes back to my early days as an IBCLC-in-training when a mentor introduced me to the subject. Over the years I have sought out continuing education and training working with babies with ties. I can guide you through all stages from suspicion to diagnosis, treatment options and post-treatment care.

When an oral evaluation is recommended, you will be provided with a list of trusted referrals. The type of healthcare professionals that can diagnose and treat ties in infants are otolaryngologists (ENTs), board certified pediatric dentists (not all pediatric dentists are board certified), and pediatricians that are specially trained to treat complex ties.

Question 17

Our pediatrician: doesn't believe in tongue tie; says tongue tie diagnosis is a fad; diagnosed a minor tie in our baby but said it shouldn't be causing issues; says a tongue tie release doesn't always help.

Accepted Answer

Tethered oral tissue (ties) is well researched, long established, and widely accepted as a root or contributing cause to breastfeeding problems. Pediatricians should be supportive, not dismissive.

Question 18

Do all tongue ties need to be treated?

Accepted Answer

Nope. Some babies have ties and require little intervention, some families choose not to treat or to wait. It varies and is a personal and private decision.

Question 19

Do you help with exclusive pumping, formula feeding, or weaning?

Accepted Answer

Absolutely.

Question 20

My baby won’t take a bottle. Can you help me?

Accepted Answer

These cases can be tough, but I like to try to help so feel free to contact me.

Question 21

I need to start pumping to build a stash for going back to work. When should I start?

Accepted Answer

Ooh, I love pumping consultations. It would be best to start forming a plan at least a few weeks before you return to work, and it is never too soon. Please contact me to talk about your needs and timeline.

Question 22

I have a question about breastfeeding/pumping and alcohol/cannabis/recreational drugs and tbh I'm hesitant to ask because I'm afraid my parenting will be judged.

Accepted Answer

I have experience working with clients on these topics and I am a safe space for your inquiry. Feel free to contact me by email at lorathomasibclc@gmail.com,(lorathomasibclc@gmail.com) call or text me at 310-776-5363, or use the contact form (javascript:void(0))on this website. For trusted scientific information visit the Texas Tech Infant Risk Center, w(https://www.infantrisk.com/)here you can search a database on medications/drugs and breastmilk. Dr. Hale's work is fantastic.

Question 23

What are some reliable online breastfeeding resources?

Accepted Answer

Ditch the Dr. Google rabbit hole for these trusted resources:

Dr. Jack Newman, International Breastfeeding Centre(https://ibconline.ca/)

Kellymom Parenting & Breastfeeding(https://kellymom.com/)

Breastfeeding USA(https://breastfeedingusa.org/)

La Leche League(https://www.llli.org/breastfeeding-info/)

Laid back nursing(https://www.mothering.com/threads/many-moms-may-have-been-taught-to-breastfeed-incorrectly-surprising-new-research.1623877/)

Center for Disease Control—Infant and Toddler Nutrition(https://www.cdc.gov/nutrition/infantandtoddlernutrition/index.html)

U.S. Dept. of Health and Human Services—Office on Women’s Health(https://www.womenshealth.gov/)

American Academy of Pediatrics—Healthy Children(https://www.healthychildren.org/English/Pages/default.aspx)

United States Breastfeeding Committee—State Coalitions Directory(http://www.usbreastfeeding.org/coalitions-directory)

Dr. James McKenna, University of Notre Dame Mother-Baby Behavioral Sleep Laboratory(https://cosleeping.nd.edu/)

Tummy time tools from Children's Healthcare of Atlanta(https://www.choa.org/tummytimetools)

Childhood development and parenting topics from Rachel Coley, Pediatric OT(https://www.candokiddo.com/about)

Elizabeth Pantley, The No Cry Sleep Solution(https://www.nocrysolution.com/advice/the-no-cry-sleep-questions-answers/)

Women, Infants, and Children (WIC) Breastfeeding Support(https://wicbreastfeeding.fns.usda.gov/)

Question 24

How long do people usually breastfeed?

Accepted Answer

It varies a lot.  Any amount of time and effort put into breastfeeding is beneficial. The American Academy of Pediatrics (AAP) (https://publications.aap.org/pediatrics/article/129/3/e827/31785/Breastfeeding-and-the-Use-of-Human-Milk)recommends that infants be exclusively breastfed for the first 6 months with continued breastfeeding--along with introducing appropriate complementary foods--for up to 1 year of age or longer. The World Health Organization (WHO) (https://www.who.int/health-topics/breastfeeding#tab=tab_1)also recommends exclusive breastfeeding up to 6 months of age with continued breastfeeding along with appropriate complementary foods up to 2 years of age or longer. Both the AAP and WHO state that mothers should be encouraged to breastfeed their children for at least 1 year. Research shows the longer an infant is breastfed, the greater the protection from certain illnesses and long-term diseases. The more months or years a woman breastfeeds (combined breastfeeding of all her children), the greater the benefits to her health as well.

Question 25

My relative/friend/coworker told me not to eat certain things. What foods do I need to avoid when I'm breastfeeding?

Accepted Answer

Dr. Jack Newman, a pediatrician and IBCLC who founded and operates the world-renowned International Breastfeeding Centre (https://ibconline.ca/)has a great take on breastfeeding and diet. His view: mothers should eat whatever they want without restriction. I concur. I highly recommend his post from 2019 (https://www.facebook.com/APPPAH/posts/foods-to-avoid-while-breastfeeding-dr-jack-newman-sets-the-record-straight/1163874790463677/)that picks apart your average What to Eat When Breastfeeding infographic, and here is another post from 2015 (https://www.facebook.com/DrJackNewman/posts/this-post-is-about-food-restrictions-and-what-breastfeeding-mothers-should-eat-a/455268277957557/)that stands the test of time.

Question 26

My doctor (or someone else) told me I should stop breastfeeding (temporarily or completely). Do I really have to?

Accepted Answer

There are rare exceptions when breastmilk or breastfeeding is not recommended. A mother does not need to stop breastfeeding due to clogged ducts or breast infection. Only a few medications or medical procedures are contraindicated (not recommended) while breastfeeding; similarly, only a few known illnesses preclude one from breastfeeding or feeding their baby their breastmilk. Although many medications do pass into breast milk, most have little or no effect on milk supply or on an infant’s well-being. You can click here (https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/contraindications-to-breastfeeding.html)to learn more about contraindications to breastfeeding.

Question 27

What legal rights and protections do breastfeeding/pumping mothers have?

Accepted Answer

California supports your right to breastfeed/pump with laws that go beyond federal protection.(http://californiabreastfeeding.org/breastfeedingrights/california-breastfeeding-laws/)
A mother may breastfeed her child in any location, public or private, where the mother and child are authorized to be present. Cal. Civil Code § 43.3.
Breastfeeding mothers may postpone jury duty for one year and do not need to appear in court to request postponement. The one-year period may be extended upon written request of a mother. Cal. Civil Code § 210.5.
Employers must provide a reasonable amount of break time and a private room, other than a toilet stall, for a mother who desires to express milk. Cal. Labor Code §§ 1030-1033.
Hospitals must make available a breastfeeding consultant or alternatively, provide information to the mother on where to receive breastfeeding information. Cal. Health Safety Code §§ 123360, 123365.
The procurement, processing, distribution, or use of human milk for purpose of human consumption is considered to be a service rather than the sale of human milk. Cal. Health Safety Code §§ 1647.
The Legislature finds and declares that all protections, rights, and remedies available under state law, except any reinstatement remedy prohibited by federal law, are available to all individuals regardless of immigration status who have applied for employment, or who are or who have been employed, in California. Cal. Labor Code Section 1171.5

Question 28

Is it legal/illegal to breastfeed in public? Do I have to cover up?

Accepted Answer

It is legal and you do not have to cover up. All 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands have laws that specifically allow women to breastfeed in any public or private location where the mother and child are authorized to be present. A mother does not have to cover her breasts when nursing. Visit the National Conference of State Legislatures (https://www.ncsl.org/research/health/breastfeeding-state-laws.aspx)to learn more about federal and state laws that protect and support breastfeeding.

Question 29

Can I travel by plane with my breast pump and expressed breastmilk?

Accepted Answer

Air travelers are permitted by the Transportation Security Administration (TSA) to bring breastmilk more than 3.4 ounces in their carry-on baggage, and it does not need to fit within a quart size bag. Ice packs, freezer packs, and other accessories needed to keep the liquid cool are also allowed in carry-on bags. A baby does not need to be present for the mother travel with her breastmilk in her carry-on bags. All liquids and partially frozen accessories are subject to being screened by X-ray. TSA is required by the Bottles and Breastfeeding Equipment Screening Act (BABES act) to provide ongoing training to ensure TSA staff receive consistent training related to traveling with breast milk, formula, and infant feeding equipment. Visit the TSA website (https://www.tsa.gov/travel/security-screening/whatcanibring/items/breast-milk)and the CDC Travel Recommendations for the Nursing Mother (https://www.cdc.gov/nutrition/infantandtoddlernutrition/breastfeeding/travel-recommendations.html)to learn more about traveling with breastmilk.

Question 30

I have a question that is not listed here. Can I submit it for an answer?

Accepted Answer

Sure! You can text or call me at 310-776-5363, email me at lorathomasibclc@gmail.com, or use the contact form (javascript:void(0))on this website.