05/23/2026
A home visit can make a big difference in a mothers success ❣️❣️
I think our field needs to have more honest conversations about what meaningful clinical experience in lactation actually looks like.
A growing number of new lactation consultants are obtaining a large portion of their experience through virtual consultations, online simulations, and screen based interactions. And while virtual lactation support *absolutely* has a place and can be incredibly beneficial for many families, I do not think it should be treated as equal to extensive hands on clinical experience.
Breastfeeding is one of the most individualized and clinically nuanced areas of maternal infant health. It is not just giving feeding advice over a secured video platform or sending positioning graphics through messages. It is assessing a real mother and baby together in real time, often during physically and emotionally vulnerable moments.
There are things you simply cannot fully appreciate through a screen.
You cannot always accurately assess milk transfer virtually. You may miss subtle oral dysfunction. You may not catch slight jaw asymmetry, tension patterns, weak suck mechanics, ni**le blanching, edema, breast tissue changes, or positioning issues that become obvious the moment you are physically present. You cannot feel breast fullness, assess tissue softness, evaluate fl**ge fit with the same accuracy, or observe the complete feeding dynamic from every angle.
In person clinical work also teaches things that are difficult to explain in textbooks or virtual modules. Pattern recognition. Clinical intuition. The ability to rapidly troubleshoot. The ability to adapt support in the moment based on infant cues, maternal stress, NICU complexity, postpartum complications, prematurity, or feeding refusal.
Working face to face with hundreds or thousands of dyads builds a level of clinical judgment that cannot fully be replicated online.
And this is not an attack on virtual care. Virtual lactation support has increased accessibility tremendously, especially for rural families, mothers without transportation, postpartum mothers recovering at home, and families needing follow up support. It can absolutely be helpful, supportive, and sometimes even life changing.
But acknowledging the value of virtual care should not mean ignoring its limitations.
Some newer lactation professionals are entering the field with very limited in person clinical exposure while simultaneously presenting themselves online as highly experienced experts. That concerns me because breastfeeding problems are not always simple, and families deserve providers who understand how to recognize complexity, when to refer out, and how to assess beyond what is visible through a camera.
There is also a difference between memorizing breastfeeding information and clinically applying it. Social media has created an environment where anyone can sound highly knowledgeable by repeating popular talking points, using medical terminology, or sharing aesthetically pleasing educational content. But real clinical skill is developed through direct patient care, repetition, mentorship, mistakes, observation, and years of experience.
You learn differently when you are sitting beside a mother who is crying from pain while trying to feed her newborn. You learn differently when you are helping a NICU mother establish milk supply after a traumatic delivery. You learn differently when you are managing severe engorgement, poor infant weight gain, ineffective transfer, oral restrictions, or complex feeding situations in real life rather than hypothetically.
Hands on experience matters.
Clinical exposure matters.
Being physically present matters.
Our credential should represent more than passing an exam. Families deserve providers who combine evidence based knowledge with strong real world clinical experience, humility, ongoing education, and the ability to provide individualized care rather than generalized internet advice.
