I will ask for your medical history.

• Any chronic physical or mental conditions, ex: hypothyroidism, diabetes, high blood pressure, depression, anxiety, ADHD, etc. - anything you take medicine for daily (or used to, before pregnancy)

• How many times you have given birth and how many times you have been pregnant.

• Miscarriages are relevant because your breasts change during pregnancy and miscarriages may occur due to hormonal factors, which may also influence milk supply. You do not have to disclose any details about miscarriages or abortions.

I will ask your birth details, such as if your birth was induced and what medications you received. 

Breast exam: I do not always need to perform a physical breast exam. If you do not want me to touch your breast, please tell me and I will do by eye only. With gloves on, I may feel your breast/chest with my fingers. I may "walk" my fingers across or with the tips of my fingers "smoosh" against the side, top or underneath the breast. The medical term is "palpate", which means to feel for texture, look for any lumps, tenderness, anything warm or swollen. I will not "grab" or "squeeze" your breast.

Nipple exam: By eye only. Very rarely do I need to touch nipples. If you have nipple damage, I will observe and find the cause of the damage, either from what the baby's mouth is doing, from what your pump is doing, or any other factors. I will not "pinch" your nipples.

Infant exam: Gently, I will test your baby's arm movements (can they raise their arms) and observe baby's neck motion while being carefully supported. With gloves on, your baby will suck on my finger. This is how I can feel what the baby's tongue is doing. I may feel around their mouth, lips, cheeks, chin with my fingers.

will touch baby, your arm, chest, or hand while changing how you hold your baby to attach them onto your breast

may touch your breast for support/shaping while baby is trying to latch

may touch your baby's mouth while they are latched on

will move around your body (I stand beside you or above you) so that I can observe for signs of active feeding, your comfort and your baby's comfort

will observe your nipple after your baby comes off, looking for signs of damage or discomfort

will touch baby, your arm, chest, or hand while changing how you hold your baby to introduce a bottle

may change baby's position depending on age, size, stress, or how they are moving their mouth or body, ex: they may be sitting upright or laying on their side

may touch your baby's mouth while they are latched onto the bottle

will move around your body (I stand beside you or above you) so that I can observe for signs of active feeding, your comfort and your baby's comfort

will measure your nipple with a ruler, which may make light contact with your breast

will closely observe your nipple while in the pump and after coming out of the pump

may touch your breast or the pump flange as it is on your breast