Lactation consultants - breastfeeding support

Breastfeeding looks simple… until you actually give it a try. A study by UC Davis Medical Center found that out of 418 women who were planning to exclusively breastfeed, 92% experienced a variety of issues with breastfeeding (e.g., incorrect latch, pain during nursing, or insufficient milk production) three days after birth, and 21% stopped breastfeeding two months after birth [1]. The New York Times reported that most mothers struggle to make breastfeeding work: “by three months, a third of infants were exclusively breast-fed in 2006; by six months, 14% [2]"

Breastfeeding and pumping are learned skills and getting support from a trained lactation professional early on can make a significant difference in achieving success. In fact, the Journal of the American Academy of Pediatrics [3] and Breastfeeding Medicine [4] found that prenatal and postnatal support from lactation consultants improved both breastfeeding intensity and duration.

Who are lactation consultants?

Lactation consultants are trained professionals who specialize in lactation and breastfeeding. Lactation consulting is a largely unregulated industry with variability in requirements across states, with some states not requiring a license for someone to be a lactation consultant. However, many lactation consultants have the credentials of "IBCLC" or "CLC" after their name – here is what these credentials mean:

• ‍IBCLC® – International Board of Certified Lactation Consultant. The International Board of Lactation Consultant Examiners [5, 6] is the gold standard for lactation certification and requires completion of both 90 hours of breastfeeding coursework and hundredths of hours of clinical practice before the certification exam. IBCLCs are also required to certify by continuing education or re-taking an exam every 5 years to stay up-to-date on the latest advances in the field of lactation.
• CLC® – Certified Lactation Counselor. CLCs are certified by the Academy of Lactation Policy and Practice [7]. They are required to take about 45 hours in breastfeeding coursework, with curriculum guided by WHO and UNICEF standards, followed by an exam. 

In addition to IBCLCs and CLCs, there are lactation counselors that are certified through other programs, like Childbirth International [8]. However, IBCLC is considered the gold standard for lactation certifications.

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How can lactation consultants help you?

• Teach you how to position your baby and achieve a proper latch
• Prevent and manage common breastfeeding challenges (e.g., pain during nursing, latching difficulties, breast engorgement, low milk production, pain during pumping)
• Show you the ropes of pumping (e.g., setting up your pump and showing you how to use it)
• Develop a plan for breastfeeding and pumping when you need to be away from your baby (e.g., returning to work)
• Manage challenging breastfeeding situations (e.g., breastfeeding twins or preemies)

Overall, getting lactation support can make you feel more comfortable and confident in your breastfeeding journey. Remember that you do not need to have a problem to schedule a consultation. 

What to consider when choosing a lactation consultant?

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When to find a lactation consultant:

• We strongly encourage you to find a lactation consultant before giving birth. There are so many things to do when your baby first arrives and searching for a lactation consultant if you are already experiencing breastfeeding issues could add to your stress.

Where to find a lactation consultant:

• Talk to your childbirth educator or friends and colleagues for references
• Ask if your hospital has one on staff – many do
• Visit the International Lactation Consultant Association’s (ILCA) website [9] to find IBCLCs in your area
• Check with your insurance company - this takes the guesswork out of whether the visit will be covered

Credentials:

• What certification do they hold (e.g., IBCLC, CLC)? 

Experience:

• How long have they been practicing?
• Do they have specific experience with something that might be a concern for you?
• Where do they practice?

Personal fit:

Don’t be shy about asking questions and making sure they are the right fit for YOU (even if they come recommended by a friend).

• What is their philosophy on feeding infants and does it align with yours?
• Do you connect with them and can you trust them?
• Are they good at listening?
• Trust your gut on this one :)

Pricing:

• What are their fees and what insurance (if any) do they take?
• Do they work directly with the insurance or will you have to submit a claim yourself?

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Can you get lactation consultant support during the COVID-19 pandemic?

Yes, lactation consultants are making sure they can provide support during these challenging times. Depending on what works best for both you and the lactation consultant, you might be able to:

• Schedule a telemedicine visit
• Do an in-person visit with a lactation consultant who takes extra safety precautions during the pandemic

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[1] https://www.npr.org/sections/health-shots/2013/09/23/225349120/to-succeed-at-breast-feeding-most-new-moms-could-use-help

[2] https://www.nytimes.com/2010/02/21/nyregion/21freda.html

[3] https://doi.org/10.1542/peds.2005-0435

[4] https://doi.org/10.1089/bfm.2011.0003

[5] https://iblce.org/

[6] https://ilca.org/why-ibclc-falc/

[7] https://www.alpp.org/certifications/certifications-clc

[8] https://childbirthinternational.com/lactation-counselor/ 

[9] https://ilca.org/