For some women, breastfeeding comes relatively naturally and easily. But for many, it can be an intense emotional and physical struggle. That’s where lactation consultants come in.
Many mothers understandably want to naturally feed their babies, given the many health benefits of breastmilk—not to mention, the American Academy of Pediatrics’ recommendation of breastfeeding for the first year of life and the seemingly increasing societal pressures to breastfeed. But the process can be very stressful, leading some to seek the expertise of lactation consultants.
“Lactation consultant” is a bit of a misleading, catch-all term, however. There are many professionals out there who provide breastfeeding help, but it’s important to understand that there are differences between the numerous certifications available to practitioners.
Of the many certificate programs out there, a Certified Lactation Counselor (CLC) is the most rigorous, requiring 45 hours of training and completion of an exam. Certified Lactation Specialist (CLS), Certified Lactation Educator (CLE), and Breastfeeding Counselor (CBC) are other certifications that practitioners can receive along the way—but they all lead up to the cream of the crop: The International Board Certified Lactation Consultant (IBCLC).
“In the world of lactation, there are so many types of helpers that we call it an 'alphabet soup' of titles. Most of them have about a week's training, and are great at helping with normal breastfeeding questions and with healthy babies and parents,” explains Kristin Cavuto, MSW, LCSW, IBCLC, RLC.
However, becoming an IBCLC takes years of training in lactation-specific science education and many hours of in-person, hands-on learning. Prospective consultants need to pass the IBCLC Board Exam, which is offered worldwide and only twice a year. It is also mandated that IBCLCs continue their education and testing to keep their status.
Deciding to seek the guidance of a lactation consultant is up to the individual family of course, and there can be costs involved. The Affordable Care Act requires lactation services to be covered by insurance. Cavuto notes however that only a few insurance companies have in-network IBCLCs, and the rest will reimburse you after paying out of pocket or with your health savings account. Private practice/home visit costs will vary by region, running anywhere from $100 per session in rural areas to close to $400 in New York and San Francisco.
“We treat new parents and babies with every type of nursing challenge, from those with basic questions all the way to those with serious problems,” Cavuto says. “We assess the parent and baby and provide an ongoing treatment plan for the issues that they are experiencing.”
Among those issues are damaged nipples, latch difficulty, low supply, oversupply, sore nipples, transition from NICU, responsible supplementation, tethered oral tissue in infants, parents with complicated health issues and nursing problems, as well as positioning, infant care education, and family adjustment help.
IBCLCs can operate in hospitals, clinics, and private offices, and many lactation consultants do home visits. “We come to the new family and help them in their own space,” Cavuto explains. A typical home visit lasts about two hours and includes a health history and physical exam of both the nursing parent and the baby. At this time, the lactation consultant will also perform an assessment of the baby’s latch and milk transfer and the mother’s supply. The goal of the visit is, ultimately, to come up with a treatment plan the nursing parent can follow to begin solving the nursing issues, says Cavuto.
Breastfeeding issues don’t only arise in the very beginning of a baby’s life. Parents can struggle with supply issues at any time. Thankfully though, Cavuto says that IBCLC’s expertise extends deep into the childrearing process. It’s never too late for a parent to seek out the help of a lactation consultant, according to Cavuto. “The IBCLC is the infant feeding specialist of the healthcare team. We help with the preemie, newborn, infant, toddler, and older nursling.”
While some parents are reluctant to supplement with formula, Cavuto is adamant that there’s nothing wrong with it, noting that “responsible supplementation is a part of many plans.” In fact, it satisfies the first rule the IBCLC lives by: “We feed the baby,” stresses Cavuto. The other two rules?
“Second, we meet our clients where they are—your goals are our goals,” says Cavuto. “Third, we support the whole family, caring for your physical and emotional needs at this very vulnerable time.”