Prenatal breastfeeding consultations can be incredibly helpful and important. In fact, I recommend them to everyone. Often, the health care provider managing your prenatal care will be very busy and appointments are likely brief. They might not have the time to thoroughly discuss breastfeeding during regular appointments. Additionally, they might not have specialized training in lactation, which can make finding someone like a lactation consultant or a breastfeeding medicine specialist extremely beneficial.

Many people think about their infant feeding plans and feeding goals while they are pregnant. But people often don't realize that they can get help ahead of time (BEFORE there are problems) if their goals include providing their baby with their breast milk. Even if you have no history of breastfeeding difficulties or concerns, gaining knowledge about how the first days and weeks after birth typically go, what to expect, and how to prepare can be very empowering. This information can lead to a more positive and informed breastfeeding experience, and overall better mental health. Feeling prepared is empowering in itself, and having appropriate and realistic expectations for your breastfeeding journey can really make a difference in preventing postpartum depression or anxiety.

Certain individuals, however, may particularly benefit from a breastfeeding medicine or lactation consult due to specific risk factors. Here are some key scenarios where a consult can be especially valuable:

1. History of Breastfeeding Problems: If you had issues with a previous baby —such as low milk supply, high milk production, recurrent mastitis, severe nipple or breast pain or damage, reliance on a nipple shield, the (unchosen) need to do exclusive pumping, to name a few — a consult can help identify these common breastfeeding problems, consider their causes and also strategies to prevent them this time around. It can also be helpful to debrief emotionally prior to going into your next breastfeeding journey as some truly suffer from Post Traumatic Stress Disorder after a bad personal experience with breastfeeding.

2. Medical Conditions: Pregnant individuals with conditions like diabetes (both gestational and underlying), hypertension (gestational or chronic), autoimmune diseases, or other chronic illnesses may face unique breastfeeding challenges.
   Breastfeeding can also be challenging for babies with medical problems, ranging from prematurity to a known congenital birth defect or debilitating syndrome. But that doesn't mean these babies can't breastfeeding or drink their parent's human milk. In fact, breast milk has so many great qulaities that fragile babies are often the ones who benefit from breast milk the most. A consult can provide tailored advice to manage these baby and maternal challenges effectively.

3. Advanced Maternal Age: Being over 35 years old can sometimes introduce additional difficulties, even if you had a smooth breastfeeding experience when you were younger.

4. History of Breast Surgery: Any previous breast surgeries or atypical breast development can impact breastfeeding. A specialist can assess your situation and offer guidance to optimize your breastfeeding journey and empower you by helping you to have realistic expectations (many women with a history of breast surgery can and do breastfeed successfully!).

5. Infertility or Infertility Treatments: There are likely some shared physiologic or developmental features that are shared by people wtih infertility as well as people with low milk supply. Those who have experienced infertility or undergone fertility treatments may benefit from a prenatal lactation consultation or more specifically with a breastfeeding medicine or lactation doctor to understand how this may affect their journey and complicate reaching their breastfeeding goals.

These are just a few examples of situations where a prenatal breastfeeding consult can be particularly advantageous. Remember, seeking expert advice and support can make a significant difference in your breastfeeding journey, helping you feel more confident and prepared.

If you have any concerns or simply want to ensure the best possible start to breastfeeding, don’t hesitate to reach out to a lactation consultant (also known as International Board Certified Lactation Consultant (IBCLC) or with a doctor who has specialized expertise in lactation care. Your journey can be smoother and more successful with the right support and information.