10 Q&As with Amy Bohler, Lactation Consultant

Q&A Session with Champions’ IBCLC, Amy Bohler

Bringing home a new baby is a joyous feeling! Those feelings can quickly turn from joy to anxiety when you’re a mom who is having a hard time getting your child to breastfeed. Breastfeeding is a learned activity. The best techniques and tricks can be best taught by a highly trained and certified lactation consultant. 

Did you know? International Board Certified Lactation Consultants (IBCLCs) are considered the gold standard when it comes to professional breastfeeding support, but a private consultation with an IBCLC can cost upwards of $175 per visit! At Champions for Children, our unique abcProgram offers the only completely no-cost, universal access breastfeeding support program in Hillsborough County.

As part of our series during Breastfeeding Awareness Month, this week, we sat down with Amy Bohler to answer some of the common questions parents have regarding breastfeeding and how a certified lactation consultant can help. Amy is the Manager of Prenatal and Lactation Services at our abcProgram and an International Board Certified Lactation Consultant. She has 10 years of experience in helping moms reach their breastfeeding goals.  

Amy Bohler, IBCLC and Manager of Prenatal and Lactation Services at Champions for Children

Q: What is an IBCLC? 

A: Those letters stand for International Board Certified Lactation Consultant. IBCLCs are considered to be the gold standard in breastfeeding support. In addition to college level coursework, IBCLCs must obtain 90 hours of breastfeeding education as well as at least 500 supervised clinical hours.

Q: What can IBCLCs help moms-to-be with? 

A: It’s great for pregnant women to take a class with an IBCLC to learn how to get a good start with breastfeeding, how to make milk, and how to tell if your baby is getting enough to eat. If mom has a specific concern such as medical condition, planned c-section, early return to work, medication, previous traumatic breastfeeding experience, it’s great to have a one on one chat to work through those concerns and make a plan to get the best possible start with breastfeeding. One of the best reasons to meet with an IBCLC in pregnancy, though, is so you already have a relationship with one. That way, you’re not googling at 3am crying because your baby won’t latch.

Q: What are some reasons to check in with an IBCLC? 

A: Pain, difficulty latching, concerns over baby’s weight gain are common reasons moms contact us. You don’t have to have a problem though! Lots of moms check in with us for reassurance that all is going well.

Q: How does a mom know if her baby is full and/or getting enough milk? 

A: Babies eat really frequently in the early days, so it’s important to know how to tell your baby is getting enough to eat. Babies should eat at least 8 times in 24 hours – they’ll probably eat a lot more than that though! Breastfeeding should be comfortable and the baby should relax at the end of the feed. 

Babies should be making appropriate diapers—one poop and one wet on the first day of life, two of each on the second day of life, three of each on the third day of life, and four poops and about 6 wets a day after that. Poop should be green by day 4 and yellow by day 5. It’s a common myth that breastfed babies can go days without pooping—the age of the baby is a key factor here. A baby in the first month of life that isn’t pooping appropriately is a baby that’s not getting enough to eat! All babies lose a little bit of weight but should be back to birth weight by 2 weeks and gaining 3 to 7 ounces a week after that. Moms should check in with an IBCLC and their pediatrician if they are worried their baby isn’t getting enough to eat. 

It’s also good to know what AREN’T signs that your baby isn’t feeding well: soft breasts, babies that want to be held all the time, a baby that will take a bottle after a breastfeed, and pumping output are NOT good indicators of how much the baby is getting at the breast.

 

Q: What’s the best way to hold/position a baby while breastfeeding? 

A: All moms and babies are unique in their temperaments and anatomy so each mom-baby dyad will look a little different while breastfeeding. It is important though, that the baby’s head be in a straight line over her hips and shoulders and that she is able to tip her head up. Baby needs to have her whole front against mom’s body and mom’s hand needs to not be putting pressure on the baby’s head. These conditions can usually be met in any of the traditional breastfeeding holds (cradle, cross cradle, football, or side-lying) or mom and baby can figure a way to get comfortable that is totally unique to them.

 

Q: How long is a consultation with you?  A follow-up visit? 

A: Our visits vary based on the complexity of the situation and cooperation of the baby, but usually between 1 to 2 hours. Same with follow up.            

Q: What does each visit include/consist of? 

A: At an initial visit, we will take a history of the birth and mom and baby’s medical history, talk about mom’s concerns and her feeding goals. We weigh the baby and observe a feed. During the feed we try to get mom and baby in a position that is pain free for mom, and optimal for milk transfer. We will weigh the baby afterward and discuss how that feed went and come up with a plan to reach mom’s goals. Based on the situation, we will refer to any appropriate health care providers and schedule a follow up visit.

Q: How much does each visit cost? 

A: The abcProgram is generously funded by The Children’s Board of Hillsborough County so all our services are free to families in Hillsborough County. The going rate of a home visit in the Tampa area is about $175 per hour. We are grateful to be able to offer this service to families who would not otherwise be able to see an IBCLC.

Q: What resources or teaching materials do you provide at visits? 

A: We have a variety of evidence informed handouts that we give to families to reinforce the education discussed at our visits.

Q: Do you offer support groups or follow-up support? 

A: Moms are welcome to visit us as often as they need to, as well as contact our warm line (813-817-8084) for continued phone support. We do not have a support group because there are many mother to mother resources in this area for continued support. Baby Bungalow has a (currently virtual) support group for caregivers of babies under one year, called My First Year, that we encourage our families to attend.