When to ask for help

Need Help?  When to ask for help….

Baby is older than 3 days old and is still not latching.

Baby is older than 5 days old and mom’s nipples are painful, blistered or cracked.

Baby is 7 days old and you are having to supplement.  Or you feel like your milk has not come in yet.

Baby is not having adequate wets or dirties without having to supplement.   A simple guideline is one wet and one dirty per day of age each day until baby is 5 days old.  After that, 3-5 dirties per day with at least one of them equal to a tablespoonful, plus 6-8 wets. Use diapers with a line that turns blue to help you track wets since babies have very small bladders and it’s easy to miss a wet. 

Baby has not gained back to birth weight by 2 weeks of age.

Baby is wanting to nurse every hour or for more than an hour at a time around the clock.

Mom is tense, exhausted and feels unable to relax while breastfeeding. Persistent neck, back or breast pain.

Mom’s breasts do not soften with breastfeeding and painful lumps remain. If mom has a fever over 101, she should contact her healthcare provider for assistance.

Other situations where help might be needed:

Adoption – induced lactation.  Yes, it is possible to bring milk in and create a breastfeeding relationship between you and your adoptive baby.


Visits: 1875

What to do till the lactation consultant gets there

Baby refusing the breast?
Milk supply low?
Baby not getting enough?

Remember these 3 things:
1. Feed the baby!
2. Protect your milk supply!
3. Make the breast a happy place!

Feed the baby.The amount a baby needs depends on his or her age and size. Babies between one to 6 months need around 24 ounces of breast milk per day. A 3 day old baby needs at least 4 oz per day, a 5 day old needs 8 oz, etc. A baby who is latching effectively may actually take more than these amounts from your breast. If your baby is under a week old and you believe he or she is not getting enough from direct breastfeeding, try offering small amounts of expressed breast milk by spoon, cup or finger-feeding with a syringe. If your baby is older and requires more than an ounce at a feeding, you may consider using paced bottle-feeding techniques for giving extra milk.

Protect your milk supply. Breast milk production is controlled by hormones in the beginning, but soon switches to local control. This means the more milk is removed from the breast, the more completely drained, the more it will produce in the next hour. When a baby is not effectively removing milk, this tells the breast that it is making too much. Using hand-expression and/or a rental-grade breast pump after feedings may be necessary to protect or build a supply until baby is able to empty the breast more easily. Research has shown that mothers who have effective breast drainage in the first three days (that is defined as 30 breastfeeds or hands-on pumping episodes in 72 hours) have twice as much milk at 10 days after delivery.

Make the breast a happy place. Keep baby skin to skin as much as possible. Baby should be between mom’s breasts, head facing to one side. Mom should be positioned comfortably, propped up with firm pillows with her back and arms supported. Breastfeeding is more than providing milk for your baby – it is setting up a relationship that starts out as meeting a physical need and transitions to meeting an emotional need between mother and child.

All breastfeeding techniques or assistive techniques should include these three concepts.

Visits: 664

How to get help

Contact by email, text or phone call (See contact page for that information) Give a little history of your issue.   We will set up an appointment according to your needs and my availability. I will respond to your contact request as soon as I am available.  We use an electronic health record system and information and consent forms are obtained before the first visit.  All appointments are conducted during daylight hours with limited availability on weekends. Please see other posts for more helpful information.

Visits: 810

What happens in a home lactation consult?

Before a consultation appointment, you will be asked to sign a consent for care, privacy and financial responsibility acknowledgement form.  The link is available under the documents tab above for you to download, complete and email back. If this does not work for you, please contact me and I will email you the form directly. I have recently switched to an encrypted, secure electronic documentation system to enable timely communication with you and your care providers. I will send you an access link to that system once our appointment is confirmed.

  1. I will obtain a history of your prenatal, birthing and breastfeeding situation up till the day of the consult. I will ask for pre and post consult pain levels. This history form is also available as a download under the documents tab. If possible, print this out and complete prior to our visit.
  2. I will do a physical assessment of your breasts and your baby.
  3. I will do before breastfeeding weights of baby or babies without and with diaper.
  4. I will do a digital suck assessment of baby sometime during the consult as needed.
  5. I will ask you to breastfeed the baby and will observe how the baby latches, your comfort level, etc. When observing the baby at breast, I will be looking for specific functional clues to any breastfeeding difficulty’s source. These clues will help us together to design a workable feeding plan. I will weigh the baby at intervals to determine accurately milk transfer with a scale sensitive to 2 grams.
  6. As the consultation proceeds, I will make suggestions as needed for increased comfort for you and baby and increasing milk transfer, as needed. This may involve special positioning, use of extra support devices, feeding aids, etc.
  7. At the close of the consult, I will provide you with a verbal and written plan of care going forward.
  8. I will provide a written report of the consult to your healthcare providers as appropriate with the information you have given me.
  9. After the consultation, I will provide continued email or text support for 2 weeks.
  10. If I think that further treatment or assessment is required by other healthcare professionals, I will tell you at the time of the consultation and also relay this to your healthcare provider.
  11. If follow-up consultation is required with me, those services will be provided at a reduced rate.

What is different about a home lactation consultation?  

  1. We will use whatever furniture and pillows you have in your home to modify the environment.   If you need something to improve your situation, I will help you figure out what that might be.
  2. You do not have to pre-register etc.  A physician’s order is not required for a home visit, although I will communicate with your healthcare provider about the visit and my findings.
  3. Visits can take the time needed to thoroughly assess your situation. Please allow at least an hour and a half for our time together. Visits CAN last up to 2.5 hours which includes history-taking, care-planning, and pumping as well as feeding the baby. There is no additional charge for this time.
  4. I do not sell or rent equipment or supplies.  If these are needed for your continued care, you will need to purchase those elsewhere. I will provide a “shopping list” for your support person, if needed.


If you would like a home consult findjanehelpsopcropped out more here.

Visits: 1643

My 35 Year Career in Breastfeeding Support

Breastfeeding is a relationship. It is not just a choice and must be honored and supported as much as possible.

Lactation care begins with the idea that breastfeeding is the natural step after birth: as natural as dessert after a meal. It is what babies and mothers were meant to do. When there is an interruption in that natural progression, questions must be asked. Is there a lack of desire, determination or direction that creates the barriers? Are these barriers coming from within the nursing pair or from without? Most difficulties can be overcome, but it takes the three items of desire, determination and direction to overcome them. My job as a health care professional is to assist your family to overcome any barriers or obstacles to breastfeeding. It’s too important to both mom and baby to not make the effort to give them the physical and relational benefits that breastfeeding provides

My story

I started out as a little girl wanting to be a nurse. While in nursing school, I became pregnant with my first child. I breastfed her as I returned to school and graduated when she was a little over a year old in 1972. This experience inspired me to turn my attention to Maternal-Child Nursing. My first job was as a labor and delivery nurse. I often helped mothers with breastfeeding. I saw the importance of education and information in the quality of a family’s birthing experience. I became a Childbirth Educator and served mothers in my community in that capacity while simultaneously working in L&D. I certified as an ASPO Lamaze Childbirth educator and started classes in Macon, Georgia and Dayton, Ohio in the following years.

In 1986, the hospital where I worked, West Side Hospital, decided to build a NICU and recognized that lactation support was vital in order for mothers to be able to provide breast milk for these fragile babies. I was chosen to participate in the education program that was available at the time with the goal of becoming an IBCLC – International Board Certified Lactation Consultant. I became certified when my fourth child was 2 weeks old.

My career since then has included numerous courses and seminars and conferences to learn more about the special needs of breastfeeding mothers and babies. In 1989, I started preparing adoptive moms for induced lactation and have enjoyed this aspect of lactation care ever since. The interesting thing about adoptive mothers is this: a mom who has never been pregnant can make milk! With that realization and vision, I find I can encourage moms who HAVE delivered, that they too can overcome whatever obstacles encountered to have a happy, satisfying breastfeeding relationship with their baby!

Over the course of my career I have worked with cleft palate and lip babies, Down’s babies, premature babies, babies with torticollis and tongue and lip-ties, moms with inadequate breast tissue, low milk supply, inverted nipples, badly damaged nipples, mastitis, plugged ducts and even cancer. I did my best to help make their breastfeeding experience as meaningful and rich as possible.

In the beginning, lactation consultants leaned heavily on the knowledge gathered by our fore-mothers – the La Leche League moms who first recognized the need for a medical arm of lactation advocacy. Over the past nearly 30 years, the knowledge base has expanded with high quality research, a professional organization, International certification, and recognition that the field of lactation care is a specialty in its own right. The tools we have today combined with a better understanding of the natural instincts that every mother and baby possess have helped bring together the art and science of breastfeeding to overcome problems that were once thought impossible to solve.

Other areas of lactation care where I have served:

In addition to one-on-one consultations for individuals I have served in the following areas:
• Coordinator of Lactation Services at Centennial Women’s Hospital for 25 years
• President of Tennessee Lactation Consultants Association for 2 years
• Committee chairman for Tennessee Perinatal Quality Initiative Breastfeeding Task Force for Centennial Medical Center –Improving Exclusive Breastfeeding in the Hospital
• Writer/lecturer for various breastfeeding education courses for nurses

Today, I am retired from over 30 years at Centennial Medical Center plus 13 years of mostly maternal and child nursing prior to this hospital. I opened my limited private home visit lactation service with the goal of  extending my experience into the home and along the way provide education and mentorship in the community.

Update:  I have enjoyed working with moms in their own environments since I opened my part-time practice in 2016.  It has been an interesting journey with many challenging situations. As of December 31, 2021, all clients will be referred to Chelsea Carver, IBCLC. Thank you to all the moms who have chosen to use my services and the hundreds of moms who have used the resources I have provided on this website.

Welcome to Hope Breastfeeding Support.

If you are interested in engaging lactation services find out more here.

Visits: 1643

5 Reasons Breastfeeding is better than Formula

You’ve heard it all over the place: breastfeeding is best for your baby. I’m going to disagree. Breastfeeding is the NORMAL way for babies to be nurtured and nourished.  Here’s why.

  1. It’s the normal diet of newborns.  All substitutes for mother’s milk are simply imitations of the original.  But when you try to imitate something – don’t you want the perfect example to start with? That’s hard when it comes to mother’s milk. Why? Because every mother’s milk is custom-made for her individual baby! And it changes according to the baby’s needs, age and environment. Breast milk composition is affected by direct breastfeeding. That’s because the mother’s breast vacuums up little bits of the baby’s saliva which contains information about baby’s system. The mother’s antibody manufacturing system then creates what baby needs and drops it back into mother’s milk for the next feedings. Breast milk is dynamic – not a static substance. As the baby gets older, content changes also with more fat for older babies who tend to spend less time at the breast and need their meal to be “on the go”.
  2. It’s the normal function of breasts. Breasts were designed to make milk. A mother stores some fats during pregnancy that are meant to provide nutrition for the coming baby. These fats are moved out of mom’s body during breastfeeding. Breast milk proteins, sugars, vitamins and minerals are consistent. Mother’s body produces the right type of milk for the baby – even when her diet varies! Failure to breastfeed may result in retained pregnancy weight. Mothers who do not breastfeed are at higher risk of metabolic syndrome, Type 2 diabetes, breast and ovarian cancer, etc. This is an area of research that has only just begun.
  3. It’s the normal location of babies. Babies are not just fed at the breasts. They learn to enjoy closeness to another human being. They listen to mother’s voice, hear her heartbeat as they did in the womb, and associate the feeding experience with comfort and security. Held close to mom, they observe the world and its newness in a safe location. Skin to skin care (the kind that happens naturally in natural breastfeeding) allows baby to use his energy resources for feeding as mother supplies warmth and support through her body.  Not only that, but the mom’s skin transfers healthy bacteria to baby’s skin which forms a first-line defense against stranger bacteria.  This benefit has been identified as one factor in reducing allergies and asthma in later life. This is important for all babies, but particularly those who have been born by Cesarean section or separated from their moms at birth for medical care.
  4. It requires a minimal amount of financial resources. Breastfeeding is less expensive. The extra food mom requires to breastfeed is much cheaper than buying formula. Even if moms need help learning and getting through rough patches in the beginning, the cost of formula is not declining. And there are hidden costs of formula that do not occur with breastfeeding – such as bottles and cleaning utensils, energy for water and cleaning, use of materials for making formula and bottles etc. Someone pays somewhere – whether it be through working a job to earn the money or through tax money supporting the “free” formula available through WIC programs. A standard-sized container of powdered formula will last about 1/2 a week and may cost up to $30. Babies under 2 months should only be given ready-to-feed formula because of the chance of contamination of powdered formulas. This is even more expensive. Babies who are breastfed have fewer infections and this also results in fewer doctor visits with co-pays, etc.
  5. It provides baby with a normal immune system. More and more research is being done to link “gut” health and overall health. Breast milk provides epigenetic factors that help a baby recognize what is “normal” and what is not. This helps reduce allergies, asthma, and many other auto-immune diseases as well as providing protection from casual infections in the baby’s environment. It is now believed that continued breastfeeding while introducing family foods during the second half of the first year helps to reduce the incidence of food allergies.  In addition, when babies who are breastfeeding receive their immunizations, the breast milk helps baby’s immune system have improved results from the immunizations. IQ, dental health and many other factors in a baby’s general health are affected by breastfeeding. When breastfeeding continues through toddler-hood, maximum benefits of breastfeeding are extended.

In summary, breastfeeding is the normal way by which babies move from the world of the womb where they are protected and fed by the placenta. As baby grows, he moves from being a totally dependent individual to an independently functioning individual. Breastfeeding provides that first step that takes this new little human being from the womb to the world.

Visits: 941