Consent for Care

This Consent for Care governs lactation support services provided by North Shore Lactation, LLC (“NSL,” “we,” “us,” or “our”). By proceeding with an appointment, you acknowledge that you have read, understand, and agree to the following. Please read this document carefully and ask us any questions before your visit — you are entitled to a clear explanation of your care in language you understand.

Last Updated: August 21, 2026

Who Provides Your Care

Lactation care is provided by International Board Certified Lactation Consultants (IBCLCs) and other qualified lactation professionals on the NSL team. Your lactation consultant is not a physician and does not provide medical diagnosis or treatment. Lactation care supplements, and does not replace, care from your own and your child's physicians, pediatricians, obstetric or other maternal health providers, and other licensed medical providers.

Purpose and Scope of Care

I am seeking lactation support services, which may include assessment, education, and guidance related to infant feeding, breastfeeding/chestfeeding, pumping, milk supply, latch and positioning, nipple/breast health, and related concerns. I understand that care may also involve review of maternal and infant health history, observation of feeding behaviors, and development of an individualized feeding plan.

Not Medical Diagnosis or Treatment

I understand that lactation consultants do not diagnose or treat medical conditions. If concerns arise that require medical evaluation or treatment, I may be referred to a licensed healthcare provider, and it is my responsibility to follow up with that provider for my own and my child's care.

In-Person and In-Home Assessment; Physical Contact

For in-home and in-clinic visits, I understand that assessment and support may involve hands-on techniques and physical contact, including assistance with positioning, latch, and examination of the breast/chest and the infant as relevant to feeding. I understand that any physical contact will be explained beforehand, that I will be asked for my permission, and that I may decline or stop at any time without affecting my care.

Telehealth and Virtual Visits

If my appointment is conducted virtually, I understand that assessment is necessarily more limited than an in-person or in-home visit, and that my consultant may recommend an in-person follow-up if a hands-on assessment is needed. Virtual visits are governed by this Consent for Care as well as our separate Consent for Telehealth Treatment, which addresses the specific technology, privacy, and limitations of virtual care.

Assumption of Known Risks

I understand that lactation care, like any hands-on health service, carries some inherent limitations and minor risks — for example, temporary discomfort during a breast/chest or latch assessment, or emotional difficulty discussing feeding challenges. I understand that my consultant will take reasonable steps to minimize discomfort and will stop any technique at my request.

Informed and Voluntary Participation

I understand that my participation in lactation care is voluntary, and that I may withdraw from care or decline any recommendation at any time. I understand that the success of any feeding plan depends on many factors, including but not limited to medical conditions, anatomy, infant behavior, and family goals, and that outcomes cannot be guaranteed.

Authority to Consent for the Infant

If I am consenting to care or assessment involving an infant or minor, I confirm that I am the parent or legal guardian, or am otherwise legally authorized to consent to care on that child's behalf.

Interdisciplinary Collaboration and Referrals

I understand that lactation consultants may work in coordination with other healthcare professionals and may recommend referrals when issues fall outside the scope of lactation care. I consent to NSL providing copies of consultation reports for myself and my baby to such other healthcare professionals, and I consent to NSL's collaboration with them, including without limitation physicians, pediatric dentists, ENTs, chiropractors, bodywork therapists, lay counselors, and other lactation consultants.

Photographs, Images, and Recordings

I understand that my lactation consultant may suggest taking a photograph, or, for virtual visits, a screen capture, to document or support care. I will always be asked for permission before any photograph or recording is taken, and I may decline. I consent to any photographs or recordings taken for this purpose being shared with other healthcare professionals involved in my or my child's care, and stored securely as part of my records.

Limitations of Care; No Guarantee of Outcomes

I understand that while lactation consultants offer evidence-based support, outcomes are not guaranteed. Recommendations are based on the information available at the time of consultation, and feeding plans may evolve as my child's needs change.

Documentation, Records, and Privacy

I consent to my consultant keeping notes regarding our consultations. I understand that all records, including any photographs, will be stored securely and maintained in accordance with applicable privacy laws, including HIPAA. The handling of my health information is further described in NSL's Privacy Policy and HIPAA Notice of Privacy Practices, which I have had the opportunity to review.

Mandatory Reporting

I understand that lactation consultants and other healthcare professionals may be required by law to report suspected child abuse or neglect, and that such reporting obligations may override confidentiality where the law requires.

Emergencies

I understand that lactation care, whether provided virtually or in person, is not appropriate for medical emergencies. If I or my baby are experiencing a medical emergency, I will call 911 or seek immediate medical care.

Financial Responsibility

I understand that payment and insurance matters are governed by NSL's Payment Policy, which I have reviewed separately. If I do not have insurance, or I choose not to use my insurance for a visit, I understand that self-pay rates are available upon request and at the time of scheduling. Under the federal No Surprises Act, I understand that as an uninsured or self-pay patient, I have the right to receive a Good Faith Estimate of expected charges before receiving care. I understand I can request a Good Faith Estimate from NSL by phone, text, or email before scheduling or at least a few business days before my appointment, and that if I receive a bill that is substantially higher (generally $400 or more) than my Good Faith Estimate, I may be eligible to dispute the bill.

Right to Ask Questions and Language Assistance

I understand that I may ask my consultant questions about my or my baby's care at any time, and that I have the right to request language assistance or interpretation services if English is not my preferred language.

Duration of Consent

I understand that this Consent for Care remains in effect for all current and future lactation visits with NSL unless I revoke it in writing, and that I may revoke this consent, or any part of it, at any time by notifying NSL, without affecting care already provided.

Updates to This Consent for Care

We may update this Consent for Care from time to time to reflect changes in our practices or for other operational, legal, or regulatory reasons. When we update the Consent for Care, we will post the revised version on this page and update the “Last Updated” date at the top. Please review this Consent for Care periodically to stay informed.

By proceeding, I confirm that I have read, understand, and voluntarily agree to this Consent for Care, and that I have had the opportunity to ask questions before my visit.

Questions about this Consent for Care? Contact us at: