Video-Consults VS. In-Person Consults: What type of lactation consult is best?

What’s best? Video-health vs in-person lactation support, in the context of a pandemic?

Our best answer is: You decide.

On a good day, welcoming a new baby in to the world is full of emotions...and welcoming a baby during a pandemic is full of all the same emotions a few (ok, a lot) of added questions.

Because brand new parents today have more to think about than any other time in recent history, it’s important that they be provided with complete information in order to do their own “benefit vs risk” assessment about all of their options in seeking care for their little ones.

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Because Breastfeeding Housecalls has spent the last 8 years visiting multiple families per day, we understand the undeniable value of an in-person visit. And, because we also want families to stay healthy more than anything during these unprecedented times, we have been able to adjust to meet the needs of new-patenting today.

Below, we break down the most important things to consider in your choice to seek out virtual vs. in-person lactation care:

VIDEO-CONSULT

• RISK: Zero risk of vulnerability to family and provider’s networks and daily activities
  
  
• AVAILABILITY: Often near-immediate availability and solutions

• RELATIONSHIP: Provides relationship-based consulting

• NON-VERBAL COMMUNICATION: Face-masks are not worn, providing ability for clients and provider to see non-verbal expressions, which are necessary in trust-building and communication

• ASSESSMENT: Near-identical visual assessment and guidance of latch, parent/baby anatomy, positioning, pumping, supply management, proper bottle feeding techniques. Experienced LCs can provide assessments of baby’s structure and function based on observation of features, feeding mechanics, client’s reporting of issues, and guided-by-LC oral assessment by parent

• REFERRALS: Provides near identical referrals (when needed) while reducing family’s general exposure by at least one provider

• CONNECTIVITY: Requires a reliable internet connection, and patience when connections are spotty; many options for accessing HIPAA-compliant care can be used during consult when connections are unreliable

• SECURITY: Because we perform our consults on secure-platforms, know that no part of the consult will be accessed by others, nor is any part of the consult recorded or saved

• PHYSICAL ACCESS: LCs do not have physical access to parent and baby, which foments a stronger parent-baby bond while receiving coaching and teaching*

• ​EQUIPMENT: Seasoned breastfeeding experts are able to assess (and teach parents how to assess) adequate milk transfer, satiation and growth without equipment. Still, for our most delicate cases, BH provides 2-7 day rental and loaner scales for local-to-San Antonio families on a case-by-case basis.

• OUTCOMES: Successful outcomes are most common

IN-PERSON CONSULT:

• RISK: 1-2-hr sustained contact (while wearing masks and practicing hand-hygiene, and as much social-distancing as possible); vulnerability to respective in-person encounters with other people and their daily activities; if consult is in-office, logistics of travel, facilty-type, etc. should be considered

• AVAILABILITY: Possible wait for appointment since in-person consults may be are scarce during social-distancing seasons

• NON-VERBAL COMMUNICATION: Limited ability to see necessary non-verbal expression due to necessary face-mask-use; non-verbal communication is necessary in trust-building and communication

• RELATIONSHIP: Provides relationship-based consulting

• ASSESSMENT: Assessment and guidance of latch, parent/baby anatomy, positioning, pumping, supply management, proper bottle feeding techniques; experienced lactation consultant can provide structural/functional assessments of baby based on observation of features, feeding mechanics, parent’s reporting, and digital suck assessment
  
• REFERRALS: May provide referrals to other in-person providers

• CONNECTIVITY: Reliability or security of internet and care-platforms are not a concern

• SECURITY: Unless parents have security cameras actively filming in their home (for home-based consults), there is zero concern that a lactation consult will be recorded or accessed

• CONTACT: Lactation consultant and parents have increased opportunities for physical contact*

• EQUIPMENT: Most in-person lactation consults have a scale available during the consult to check overall weight gain and to measure milk transfer. Most reliably, however, parents should be taught how to measure milk-transfer and thriving without a dependency on scales
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• OUTCOMES: Successful outcomes are most common

*”Low/No-Touch” encounters are a care standard appreciated by many parents and practiced during many in-person lactation consults and in nearly all support group settings. Reduced physical contact when teaching is known to INCREASE baby’s physical contact and bonding with parent.

We hope this comparison helps you arrive at the best decision for you and your family!

If you decide to troubleshoot your breastfeeding virtually, read our next blog article with tips about how to prepare for and optimize your virtual lactation consult.

At this time, in order to protect your family the most, Laura María Gruber is only doing video-consults seven days per week. You can schedule via this site, or If you don’t see a time that works for you, you can text her directly to ask about availability (she won’t provide text-based consults unless it’s to accommodate a disability). Laura is usually able to work families in quickly.