What is an IBCLC (Lactation Consultant) and how can they help me with breastfeeding?
An International Board Certified Lactation Consultant is a health care professional who specializes in the clinical management of breastfeeding. An IBCLC can work in a wide variety of health care settings such as hospitals, pediatric offices, public health clinics, and private practice. They work with new families to help them meet their breastfeeding goals. They are experienced in a wide variety of complex breastfeeding situations, and competent to assist mothers with establishing and sustaining breastfeeding, even in the midst of difficulties and high-risk situations that can arise.
The first IBCLC that I ever met was a dear friend and colleague named Jacquie. Up until that point, I had no idea that such a certification existed. Jacquie was warm, funny, and knew EVERYTHING about breastfeeding. I marveled at her ability to get almost any baby to latch. Jacquie would send a nursing mom on her way with confidence and the tools needed to be successful at breastfeeding. I became a Certified Lactation Educator in 2008. With Jacquie as my mentor, I went on to do more training and became an IBCLC (International Board Certified Lactation Consultant) in 2011. I’ve been guiding and assisting mom and baby pairs to breastfeed for 10 years!
Through my work with some incredible women and babies in the last 10 years, I have learned that most women want to breastfeed. The support of family and friends as well as help from the medical community is absolutely key to their breastfeeding success. Becoming educated on how to breastfeed, what to expect, and learning how to get a good latch during the prenatal period is crucial. It is a bit more challenging if expectant families wait to learn this information after the baby is born.
Here are 9 important things I have learned as a lactation consultant that can help women get a good start to breastfeeding.
-Choose a pediatrician who is breastfeeding-friendly. This means someone who is willing to explore all of your options if baby is not gaining enough weight, and won’t jump to supplementation with formula if it is not necessary.
-Get help right away if something isn’t right. Locate an IBCLC ahead of time who can assist you if things aren’t going well. A lactation consultant can help you with latch and positioning, weight checks, sore breasts and ni***es, pumping, medications, paced bottle feeding, and more.
-Breastfeeding is a learned skill. You learn by observing others (which doesn’t always happen in our society) and by experience and practice. Be patient with yourself and baby. You are a unique unit and you will very quickly become the expert as you learn to respond to baby’s cues.
-In the beginning, your baby will go to breast about 10-12 times in 24 hours. This is NORMAL. Remember that baby’s tummy is very small, so he will need frequent feedings. Babies go to breast for many reasons, not just hunger. At the breast they find warmth, comfort, food, and security with mom.
-You do not need to be on a special diet or eat special foods to make good milk for your baby. Simply eat a balanced, wholesome diet and stay well hydrated, and your milk will be perfect and plentiful!
-If at all possible, avoid introducing bottles or pacifiers in the first 6 weeks. Any artificial ni**le could be potentially confusing for your baby and change the way that he approaches the breast and change how he sucks. Ni**le confusion is super frustrating and can take a while to overcome, depending on the frequency by which the bottles or pacifiers have been given.
-Feed baby at the earliest signs of hunger. Don’t wait until baby is crying; this is a late cue and can make getting them latched on much harder. Watch for baby putting his hands in his mouth, making sucking movements, and soft cooing sounds or stretching.
-Look for signs of milk transfer: a) hearing the baby swallow or gulp, b) no clicking or smacking sounds, c) baby looks content after a feed, d) baby’s body and hands are relaxed, e) feeling a strong tugging but NOT persistent pain, f) baby has adequate weight gain.
-Watch the baby, not the clock! Do not put your baby on a schedule for the first few months. Feed on demand for good milk supply. Mom and baby pairs are all different, so don’t compare how much your baby goes to breast with your neighbor. Milk storage capacity varies between moms, so you may have to feed more or less often than your friend.
What does a home or office visit for lactation support entail?
I offer home visits as well as office visits. For office consultations, I use space at Prep for Birth (located on Lehman & Academy).
For the initial visit, I take down a medical history of mom and baby as it pertains to breastfeeding. During this time we also cover other important topics like what supplements the mom may be taking, postpartum complications, when breastfeeding issues started, whether baby has had formula, and more.
If baby is hungry when I arrive, we work on latch immediately if that’s what is needed! Most of the time, I am also doing a “weighted feed” to see how much milk baby is transferring. We weigh baby, feed baby from both breasts, and then weigh baby again at the end. This is important because it will help determine, along with other factors, if baby is getting enough from the breast. Sometimes baby is not up for breastfeeding for whatever reason, which usually means scheduling a follow-up visit for another try.
After baby eats and is more settled, I can check for tongue or lip tie, high palate, and other oral restrictions. I may also be checking mom for flat or inverted ni***es, and addressing other anatomical concerns that could be impeding breastfeeding. A good portion of the home visit is the educational piece---getting mom and dad up to speed on things like paced bottle feeding, using a breast pump, how much weight baby should be gaining, how often to feed baby, how many calories to consume while breastfeeding and making healthy choices, different breastfeeding positions, growth spurts, and so much more. We talk about whatever mom is concerned about and whatever might help breastfeeding go more smoothly for her.
At the end of a visit, we make a personalized plan that includes short-term and long-term goals. This is when I make recommendations based on the specific mom and baby pair and what may work best for them. A referral out to a chiropractor, craniosacral therapist, or pediatric dentist may be needed for further care. During the two weeks following a home visit, I am available through text or phone call to answer questions and adjust the plan as needed. If mom is still struggling after 2 weeks, then I usually go back out to the home and reassess.
