This article was written in collaboration with my colleague, Lyla Wolfenstein, BS, IBCLC. Lyla is a lactation consultant in Portland, OR.
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n an ideal world, every mother-baby dyad would have access to thorough, accurate, compassionate lactation support from the prenatal period through weaning. Sadly, this is not the case, and sometimes the “support” new families receive is fraught with error– informed by poor (or no) training.
When initiating breastfeeding, it’s difficult to determine which of the overwhelming number of voices are offering sound advice. Everyone from your pediatrician to your sister, your doula, and even strangers from facebook seems to have “the answer.” But are these suggestions tailored to your situation? Do they come after years of intense study? Or are they unwittingly advising actions that helped someone, but might undermine your specific breastfeeding relationship?
Renee is so knowledgeable and supportive; I feel like breastfeeding may have stalled out if I hadn’t had her guidance!
We recommend finding lactation help from a professional who meets some basic standards of education and experience. Here are a few guidelines that can help you select the right match for your situation.
1) Look for an IBCLC (International Board Certified Lactation Consultant). There is no other certification that comes close. The IBCLC requires thousands of hours of direct contact with mothers and babies, specifically helping with breastfeeding. It also requires extensive study of anatomy and physiology, child development and numerous other components critical for lactation management. The IBCLC is a “stand alone” certification. That simply means that no other license or certification is needed in order to be an IBCLC. You might also see the designation RLC – all IBCLCs are also RLC (registered lactation consultants). Only IBCLCs can use the designation RLC.
Just as one would choose a doctor rather than a medic for a thorough medical exam and treatment, so differentiates the IBCLC from other “certifications” that require only a 5 day course of instruction. To ensure your lactation consultant is indeed an IBCLC, you can check www.iblce.org. Although IBCLC is the gold standard for certification, just as in any profession, there are some practitioners who more skilled than others. Select your lactation consultant wisely.
2. Consider an IBCLC who works outside the purview of a hospital-based lactation center. While many hospital IBCLCs are wonderful, even the best are often constrained by hospital policies. Appointments are usually restricted to an hour or less so they cannot offer the degree of attention or give the same advice that independent IBCLCs may be able to provide.
3) Ask for referrals from local parenting internet groups, new mother support groups, La Leche League, your healthcare provider, friends and neighbors.
4) Visit websites of various lactation consultants in your area. You can get to know a lot about her level of experience and her philosophy with a few clicks.
5) Interview potential IBCLCs before you decide who is the best fit. Call around and ask a few pertinent questions. Check out the website first so you have some background. Some questions might include:
- General questions (you may be able to find the answers on her website):
How long have you been certified as an IBCLC?
Do you have any areas of specialty or expertise?
How long are your consultations? (1.5 hours should be the minimum length for an initial postpartum consultation, and an hour for a prenatal.)
- Technical questions:
What is your opinion of / experience with:
bottle feeding approaches that support breastfeeding?
tongue tie and lip tie?
body work / craniosacral therapy for newborns?
nipple pain in the early weeks – how do you assess for causes?
high-need babies?
low milk supply and/or slow weight gain?
The right answer to all of these is something along the lines of “These issues need to be remedied as soon as possible after the birth, and I am skilled at assessing, addressing and referring in order to do so.”
- Her level of experience with any particular area you are concerned with:
prematurity?
twins or multiples?
low milk supply and supplementation?
If you hear anything that makes it sounds like your concerns are not taken seriously, or not worth addressing, or not real, or the IBCLC is lacking in experience in these areas, that’s a red flag!
After learning the answers to these questions, you will be better equipped to select an IBCLC who reflects your understanding and seems experienced in these very important knowledge areas. You will also have a feel for the personality match and can opt for someone who helps you feel confident.
Now that you have selected your IBCLC, you are on the road to addressing and remediating your breastfeeding challenges. So…..what actually happens at a lactation visit?