I believe that breastfeeding can sometimes be the next big challenge after giving birth. Many families choose to take an in-person breastfeeding class during pregnancy. Lamaze offers an online breastfeeding class - Breastfeeding Basics: From Birth to Back to Work as another option to help expectant families to feel prepared. Ultimately, it is not until the parent-baby dyad is together that reality sets in about the breastfeeding dynamics for each particular pair.

Families may benefit from a visit with a lactation consultant in the early days as breastfeeding becomes established, but not every family has access to an International Board Certified Lactation Consultant (IBCLC) in their area. Another challenge may be transportation difficulties that present obstacles in getting to the lactation office. Finally, financial barriers may stand in the way for some families whose insurance does not cover a breastfeeding support visit with a lactation consultant.

For those families who find an in-person visit to a lactation consultant not feasible, there is now the option of a virtual visit with a professional who may be nearby in their community or halfway around the world. Some lactation consultants now offer this service, which requires the new parent to have nothing more complicated than a computer, webcam, and speakers or a even simply a smartphone or tablet. Costs vary, but the virtual visit may represent savings over the cost of an in-person consultation.

In my community, there is a Virtual Lactation Program at the MultiCare Tacoma General Hospital available to new families. This program has received a grant that makes virtual lactation services available at no cost to low-income families who are working with the local Women, Infants and Children Food and Nutrition Services office (WIC). This program is funded until 2018, at which time Medicaid will begin to pay for virtual lactation visits for qualified families.

In order to make lactation support even more accessible to new families, after hour appointments and interpreter services are available to those who need them. The staff who support the virtual program are not only International Board Certified Lactation Consultants, but also Advanced Registered Nurse Practitioners (ARNP) with prescriptive authority if there is a condition that warrants medication. Families may self-refer to the program.

The top ten common problems that are handled through a virtual lactation visit are:

1. Latching pain
2. Cracked nipples
3. Clogged/plugged ducts
4. Engorgement/high milk supply
5. Mastitis
6. Thrush
7. Low milk supply
8. Baby sleeping at the breast
9. Inverted or flat nipples
10. Painful/overactive letdown

Michelle Kinne, BA, IBCLC, ICCE, CD(DONA), Director of Cascade Perinatal Services shared her thoughts on this increasingly available support option. "Accessible and affordable breastfeeding care plays a vital role in supporting both breastfeeding duration and exclusivity. Virtual lactation support by an IBCLC is an excellent next best option when an in person consult is not feasible."

If families can get the support they need to solve early breastfeeding problems and to build confidence, both the breastfeeding parent and the baby benefit long term. Offering virtual visits and making them free to income-qualified families expands the support available to help get breastfeeding off to a good start.

Are there programs in your community that offer virtual lactation visits? Are these resources available to low-income families? If they are not, consider connecting with lactation services and letting them know about possible funding available to support these families. Do you share in your childbirth class that a virtual LC visit might be an option for some families, especially those who are recovering from a cesarean birth or who have transportation issues? As technology makes our world smaller, there are many services available to new families that can make those early days and weeks go a little bit smoother. I hope that if you do not already share about virtual lactation visits, you consider mentioning it in the future so families can benefit.

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