Prenatal Preparation
Prenatal Lactation Consultation
Set up your feeding plan, and a relationship with an IBCLC, before your baby arrives.
A prenatal consultation goes further than a class. We plan around your actual situation: your history, your anatomy, your pump, your risk factors, and your goals, before the early postpartum days begin. We review your medical history and feeding risk factors, help you choose and fit a pump, and write a care plan specific to you.
You also leave with an IBCLC who knows your history. We cannot promise that the same IBCLC will be available for an in-person visit in the first hours after birth, but you have someone you can message with questions, and we can set up a virtual triage visit soon after birth if something is not going as expected.
Most parents come in during the third trimester. Earlier visits make sense when you already know you have risk factors. We see prenatal families at our offices, in your home, or by video.
Why now
Why see someone before the baby is here
Most feeding questions show up in the first few days after birth, when you are tired and arranging outside help is harder. Latch, supply, and anatomy questions are easier to work through when you already have a plan and a number to call. Several of the conditions that affect feeding also respond best to steps started in the first hours, which is a reason to identify them ahead of time rather than after they appear.
A consultation gives you three things a class does not.
A read on your situation, not the average
A class teaches what applies to most parents. A consultation looks at your medical history, your anatomy, any previous feeding experience, and what you want this time.
A care plan in writing
You leave with a written plan: positioning, what to expect in the first days, what to watch for, and what to do if something is not working.
A head start on follow-up
When you call us after birth, we already have your history. Visits move faster and the advice is more specific because we are not starting from scratch.
Four areas of focus
What a prenatal consultation covers
Every prenatal visit covers the four areas below. The mix depends on your situation and what your IBCLC finds most relevant during the visit.
01 · Feeding risk assessment
Feeding risk assessment
We look at the medical history, anatomy, and past feeding experiences that can affect how feeding goes. Common factors include polycystic ovary syndrome, thyroid conditions, gestational diabetes, hypertensive disorders of pregnancy, a history of breast surgery, insufficient glandular tissue, a possible NICU stay, multiples, and trouble feeding a previous baby. A family history of tongue tie or other oral function differences matters too.
Finding these prenatally lets us plan around them instead of meeting them as surprises after birth. Several have specific strategies that work best when started in the first hours.
This assessment also applies if you are inducing lactation, co-nursing, chestfeeding, or planning to feed an adopted or surrogate-born baby.
02 · Pump selection, sizing, fit
Pump selection, sizing, and fit
If you will be pumping, the right pump and the right fit make a real difference in comfort and output. We walk through the pump types, help you pick what fits your situation, and check your flange sizing.
Most parents are surprised that flange sizing has changed a lot in recent years. The size that ships with most pumps is too large for most people and can cause pain or lower output. Fitting prenatally means you are not working through that postpartum.
If you have pump coverage through your plan, we help you understand your options and choose well. We do not sell pumps.
03 · A care plan in writing
A care plan in writing
You leave with a written care plan for your situation. It covers what to expect in the first 24 hours, positioning for your anatomy and any specific concerns, signs that feeding is going well, signs that warrant a call to us or your pediatrician, and when to follow up.
If you have identified risk factors, the plan also includes specific steps to start early and a suggested schedule of postpartum visits. This is your reference document. A lot of families keep it on the fridge or in the hospital bag and use it through the early weeks.
04 · A plan in place before your due date
A plan in place before your due date
By the end of the visit you have an IBCLC who knows your history, a written care plan, and a clear path to follow-up after birth. We coordinate with your pediatrician and other providers when it helps, and we can point you to lactation-friendly pediatricians, frenectomy providers, or doulas if a broader team makes sense for you.
In-person visits in the first hours after birth depend on team availability, so we cannot guarantee them. What we can guarantee is a relationship with our practice, someone you can message, and a virtual triage visit set up quickly when you need one. If you are expecting a complicated postpartum, the prenatal visit is the start of a coordinated plan that carries through the first weeks and months.
Especially relevant when
When a prenatal consultation is especially worth it
A prenatal consultation fits any parent who wants individual preparation. It is especially worth it when:
- You have a condition that can affect lactation (PCOS, thyroid conditions, a history of breast surgery, insufficient glandular tissue, diabetes)
- You had significant feeding trouble with a previous baby
- You are expecting multiples
- A NICU stay is possible
- You have anatomy concerns (history of breast surgery, hypoplasia, asymmetry)
- You are inducing lactation, co-nursing, chestfeeding, or feeding an adopted or surrogate-born baby
- You want a written plan and an IBCLC relationship before birth
- You would rather have guidance for your own situation than general class content
If none of these apply, a consultation still helps, particularly with pump selection and planning.
Classes & consultations
Classes and consultations do different jobs
Classes give groups a foundation. A consultation gives you a clinical read and a plan for your situation. Most prenatal families do both.
Class
Breastfeeding Blueprint
A class covering breastfeeding fundamentals, positioning, common challenges, and the early postpartum period.
Learn more →Class
Breast Pump Puzzle
A prenatal class on understanding and choosing a pump, including how to evaluate the pumps you may have access to.
Learn more →Class
Push It Real Good
A prepared childbirth class covering labor, delivery, and the immediate postpartum period.
Learn more →Most prenatal families pair a class with their consultation. The class gives you the shared foundation; the consultation tailors it to you.
Visit formats
Three ways to have your prenatal consultation
Most families come in between 32 and 36 weeks. If you have known risk factors or specific concerns, an earlier visit is appropriate.
In your home
An IBCLC comes to you. Useful if you want to look at your home setup as part of the planning. Home visits are limited by availability and location, and include a travel fee that is not billed to insurance.
See where we visit →In our office
See your IBCLC at one of our offices, where we have everything we need for your visit. Our offices are set up more like a living room than a typical doctor’s office. Office visits also let us care for more families and often have earlier availability, so we encourage them whenever they work for you.
See our offices →By video
HIPAA-compliant video works well prenatally, since most of the visit is conversation, history review, and building the plan. You will need a stable internet connection and our video platform installed ahead of time.
About video visits →Locations
Where we offer prenatal consultations
Prenatal consultations are available at our offices, in your home, and by video.
See all locations →Insurance & self-pay
We bill several plans directly, and self-pay is available for every visit
We verify your benefits during intake, before your appointment, so you know where things stand ahead of time.
Related pages
Also available
Microbiome testing during pregnancy (optional)
Through our partnership with Tiny Health, we offer an at-home pregnancy gut test, with a follow-up review by an IBCLC. It is optional and separate from prenatal feeding preparation. It is not required for breastfeeding and does not predict how feeding will go.
Learn more about microbiome testing →Get started
Get your plan in place before your due date
The next step is the intake form. Our scheduling team books your prenatal visit and our billing team verifies your insurance, both before your appointment.
Start your intakeOpens our intake form in a separate, HIPAA-secure system (new tab).