Do you feel like you can never put your baby down and are tethered to breastfeeding 24/7? My personal opinion is that it is not the end of the world to introduce a pacifier to your baby once your milk supply is established, and you have a good read on when your baby has fed well and is satisfied. Kellymom recommends 4-6 weeks before introducing a pacifier and I tend to agree (of course there are exceptions to every rule.) Until then, try to just let feeding frequently be the norm and let go of stresses or people who guilt you about "nursing him all the time". Trust yourself, and your baby - it is okay to feed often.
Do you feel frustrated and unsure about whether all this frequent feeding=healthy and normal or frequent feeding=starving because not enough milk? See point #2, which is...
On the other hand, if the LC finds something you can fix - now you have a way to address your issues, and you can keep working on them together if needed. You might feel like a baby who can't be removed from the breast without becoming completely frantic "shouldn't be" a problem because isn't it normal for babies to "eat all the time"? But when you go to the LC because you're completely exhausted and never sleep, you might find that the baby has difficulty transferring enough milk . Now you can work on strategies for improving the baby's milk transfer, and have a follow up visit in a few days to see if they're working.
If the person you see does not help you/listen to you/really pisses you off, find someone else. This is just like OB/midwife shopping - some people are going to be a good match, some not so much. Note: the "lactation specialist", "lactation counselor", or "lactation educator" at your pediatrician's office may be very nice, but they are not IBCLCs, and neither is your pediatrician. They may be great - they may even be better than some IBCLCs - but I have seen patients really get burned thinking they saw an LC when they didn't.
What could it actually be? Bacterial infection, vasospasm, blebs, oversupply, dermatitis, tongue or lip tie... the list goes on and on. How can you figure out which one it is? See point #2.
If you really think it might be thrush - and fine, sometimes it is! - then go ahead and treat for it. But consider the symptoms before going with that diagnosis, and don't go through multiple rounds of treatment for thrush without considering other diagnoses.
5) Most medications are safe for breastfeeding. Most healthcare providers do not know this. I have lost count of the patients and friends who have been told by doctors, nurses, and pharmacists "you have to pump and dump while taking ____". It has been true exactly twice. I have worked with people in the intensive care unit, people who are having major health crises, multiple surgeries, etc. - and all their meds were fine. And then I meet someone who got told to pump and dump for her mastitis antibiotics! NEVER pump and dump until you have independently verified that you need to - instead, pump, label the milk with the meds you are on, and save it. Then look up your meds on Lactmed and/or call Dr. Thomas Hale's Infantrisk hotline (Mon-Fri) and discuss what you learn with your doctor/midwife/pharmacist before making the final call (nb: most health care professionals are very reassured to hear that Lactmed is run by the NIH.) Jack Newman notes that the standard warnings on the label and in the Physicians Drug Reference are about legal liability, and not about the available research and understanding of med safety. PUMP AND SAVE! And educate your health care providers, if possible, to use Lactmed and Dr. Hale's hotline and book as references, not the PDR or ePocrates.
What have I forgotten? Anyone have things to add to this list that they wish they'd known?