In the past seven years I have built a very successful lactation business. I
was very nervous when I first started, but my husband offered some very sage
advice.  He said, "Shine your shoes, be available and be nice.  He also
influenced me to send a formal dictated letter to the pediatrician of every
patient I saw.  My biggest obsticle was referrals from physicians.  After
several years I learned that my consult letters were my biggest selling
point.   Living in California has probably been in my favor, because managed
care is prevelant and managed care seems to have seen the light about the
preventive aspects of breastfeeding. I am a provider for seven different
insurance plans including Medical.  I am currently applying to become a
durable medical equipment provider for one of our health plans and for
Medical.  Of course,
billing insurance means more paper work.  I now have a full time billing
person to handle my pump invoices and insurance billing and may soon go to
electronic billing.
Insurance companys were reluctant at first to make me a provider, but
patients and physicians demanded that the insurance companys work with me.
 Recently insurance companys have been calling me to ask me to be on their
provider list.  It may be helpful that I am a P.N.P.
I must confess that I could never consider running a consultant business
without renting out pumps.  I  don't know how I would pay my bills.  In order
to survive a business must always look at the market and be ready to expand.
 I teach parenting classes, sell infant stim toys, bras and nursing tops.
 The pumps and the bras probably attract the most business.  I have also set
up an environment that attracts mothers with young babies.  Mothers will stop
in to talk with my staff, nurse their babies and weigh the baby and by the
way buy a bra or toy.  Of course we are always available to answer their
questions.
It is important to realize that building a business takes time and financial
backing.  It is also to set fees that are fair and yet reflect the level of
expertise the mother and baby are receiving.  I also believe it is important
for consultants  to meet their professional responsibilities by keeping up
with the literature.