The Invaluable Wisdom of an Experienced IBCLC: Your Ultimate Guide to Breastfeeding Support

Bringing a new life into the world is a wondrous journey, but it also comes with its fair share of challenges, especially when it comes to breastfeeding. For many mothers, this can be a daunting task, riddled with uncertainties and questions. That's where the expertise of an experienced International Board Certified Lactation Consultant (IBCLC) comes in – a professional with years of invaluable experience who can be your guiding light through this incredible journey.

Understanding the Role of an Experienced IBCLC

An IBCLC is a lactation expert who has undergone rigorous training, clinical practice, and an examination to earn their certification. While all IBCLCs are equipped with the necessary knowledge to help breastfeeding mothers, those with many years of experience bring a unique set of benefits to the table.

1. Depth of Knowledge and Expertise: Years of experience mean that an IBCLC has encountered a wide spectrum of breastfeeding challenges, from the common to the complex. This depth of knowledge allows them to quickly identify issues, offer targeted solutions, and adapt their approach based on the individual needs of each mother and baby.

2. Holistic Approach: Experienced IBCLCs take a holistic approach to breastfeeding support. They understand that breastfeeding challenges often extend beyond the physical aspects and can be influenced by emotional, psychological, and environmental factors. With their wealth of experience, they can provide comprehensive guidance tailored to your unique circumstances.

3. Navigating Complex Cases: While every breastfeeding journey is unique, some cases can be particularly intricate due to medical conditions, premature births, or other complications. An experienced IBCLC has likely encountered these complex scenarios before and can offer well-informed advice and strategies that address the specific challenges you're facing.

4. Personalized Support: The experience gained over the years empowers an IBCLC to provide personalized guidance that goes beyond textbook solutions. They take into account your individual preferences, concerns, and goals, tailoring their recommendations to suit your needs and aspirations.

5. Problem-Solving Skills: Breastfeeding isn't always smooth sailing, and challenges can arise unexpectedly. An experienced IBCLC is a problem-solving maestro, capable of thinking outside the box and devising creative solutions that work for you and your baby.

6. Long-Term Benefits: Investing in an experienced IBCLC may seem expensive initially, but the long-term benefits far outweigh the cost. A well-established consultant can help you establish a successful breastfeeding routine, which can lead to improved maternal and infant health, reduced medical expenses, and a nurturing bond between mother and child.

Conclusion

Hiring an experienced IBCLC is an investment in your breastfeeding journey that pays dividends beyond measure. Their years of dedicated practice, in-depth knowledge, and holistic approach can transform challenges into triumphs, guiding you through this precious time with confidence and reassurance. Remember, the value you receive from an experienced IBCLC is an investment in the health and well-being of both you and your baby that lasts a lifetime.

Cesarean Sections and Breastfeeding ...... Donna Kimick, IBCLC, RLC

After women have had cesarean sections, it can be difficult to get breastfeeding started.  

C- Sections can still be compatible with breastfeeding and doesn’t preclude the mother from breastfeeding. The causes of this difficulty include initial recovery; the effects of surgery and anesthesia, as with any type of surgery, can cause the mother to feel too exhausted and groggy to even hold the baby right away.   If a mother receives general anesthesia, she can breastfeed as soon as she is awake and able to respond.

Some newborns tend to be a bit sleepy following an epidural or general anesthesia and may suckle with less enthusiasm at first. Starting to breastfeed as soon as possible, and focus on positions that don’t hurt the incision (football or side lying can be helpful), additional pillows in front of the incision can also be helpful.

“Milk production normally begins to increase (biochemically) between 30 and 40 hours after delivery of the placenta, but it may take a little while for the changes to become apparent to the mother. Milk “coming in” generally refers to the time when the mother notices increased breast fullness (and other signs) as milk production begins to kick into full gear– this usually occurs 2-3 days after birth, but in as many as 25% of mothers this may take longer than 3 days.” - Kellymom.com website

           Cesarean sections many times will delay milk production, it is unclear whether this is due to the stress of surgery, medications, and/or less than optimal breastfeeding management. Some mothers report not seeing any volume of milk until 5 - 7 days after delivery. Because of this delay many c-section babies are more likely to be supplemented at the hospital, which often leads to early weaning. Some hospitals encourage skin to skin immediately after delivery and initiating breastfeeding once in the recovery room. Most providers will try to prescribe safe pain medications when they know the mother wants to breastfeed.

C -section moms might require more assistance once home from the hospital to get breastfeeding off to a good start. Family members can help with positions and lifting the baby until mom heals.  Referral to an IBCLC ( International Board Certified Lactation Consultant) for consultations are vital as well. 

          Cesarean sections should not be a deterrent to breastfeed, rates and duration of breastfeeding among c-section babies are about the same as babies born vaginally. With encouragement and support breastfeeding can be successful.

Why should you Breastfeed your baby?

As a IBCLC, (Internationally Board Certified Lactation Consultant) I get this question from many pregnant mothers and their partners.

Firstly, new mothers now are so lucky to have the internet with all its information (not all true by the way), and all the support from more mothers choosing to breastfeed.  In the opinion of lactation consultants breastfeeding should be the norm in our culture, not bottle feeding formula. But since much of us were not breastfed and many others never subjected to breastfeeding growing up, it does not always feel “normal”.  It has only been the last 100 years or so that breastmilk and breastfeeding had been deemed not important enough and “formulas” were invented to nourish newborns.  Those “formulas” were not always perfect and yes some babies did die with the initial experimenting.  Doctors started specializing in different health areas and the pediatrician was formed.  Many of them tried to teach mothers to schedule and regulate mother’s breastfeeding. Thinking that they may be feeding their newborns too often and too much breast milk.  Once they scheduled the feeding of course there were less feedings. Less feedings produced less milk.  You see milk production is a “supply—demand” reaction, the more a baby “asked” for the more a mother would make.  Decrease that natural response and obviously there would be less milk.  It was then that doctors decided to start mixing “formulas” made of cows milk and sugars etc. to simulate (Similac) breastmilk.

I also get the question, well what did mothers do if they didn’t make enough milk before formula was invented?  Or did every mother just make enough milk?  The answers to those questions may surprise most.  First off not every mother made enough milk even back before formula. Believe it or not other mothers would help out, even grandmothers would feed their own grandchildren or aunts, sisters, friends and neighbors.  There are many stories of mothers waiting outside houses on lines to have a mother with an over supply feed their babies.  Mothers always do what is needed for their babies.  Of course even today many mothers do opt out of formula and get either milk via milk banks or even private donations. Yes formula is now relatively safe and is still the second option for most babies. But there is this other option that is becoming more and more common.

Obviously most mothers I meet already know they want to breastfeed, so I do not have to work too hard to convince them but the health benefits are usually the first benefits I do talk about.  Every day we hear about more studies that prove different health benefits for the baby as well as the mother.

First off is my favorite, IMMUNITIES.  Imagine if every day you could give your baby a good vaccine against another virus? That is what breastfeeding does. Whatever virus the mother comes in contact with will go through her body and if her body has seen this bacteria/virus before her immune system jumps in and creates the exact antibody to fight it.  That is how antibiotics got their name, although antibiotics are “broad spectrum” which means you never know if that prescription will actually kill that bacteria. But the mothers body knows which antibody to use and sends it through her breastmilk.  Yes breastfed babies can get sick, but studies show they “bounce back” much quicker with the help of breastmilk. 

Another benefit for babies is that breastmilk is a brain food.  There have been many studies over the years and there are recent studies.  “Young children who were breastfed as infants are smarter and performed higher on intelligence tests than their formula-fed counterparts, and the longer and more exclusively they were breastfed, the greater the difference, Harvard University researchers said.” 

 And “….each additional month a child was breastfed resulted in better language skills at 3 years old and intelligence at age 7, compared with babies who had formula milk. The study is one of the largest to analyze the impact of breastfeeding on a child's intelligence.”

So the longer a baby breastfeeds the better the outcome as well.

Which brings us to the next question… How long should I breastfeed for or how long do I breastfeed for any optimal results? 

The AAP ( American Academy of Pediatrics) recommendation:. “ The AAP recommends that babies be exclusively breastfed for about the first 6 months of life. This means your baby needs no additional foods (except Vitamin D) or fluids unless medically indicated. Babies should continue to breastfeed for a year and for as long as is mutually desired by the mother and baby. Breastfeeding should be supported by your physician for as long as it is the right choice for you and your baby “

I try to emphasis the statement “as long as is mutually desired by the mother and baby.”  Yes a year is wonderful, but telling a mother having issues at week one this could definitely be discouraging and make her feel inferior.  I tell my patients to take it day by day, week by week and month by month. Then I am pleasantly surprised to hear from a mom months or years later that breastfeeding became easier and more enjoyable and “we are still breastfeeding”. Even though us lactation consultants do not like to use the word “still”.  

The most important part of mothering is to ENJOY YOUR BABY. If breastfeeding is becoming difficult you do not have to endure until the pain in your nipples “toughen up” or “eventually the baby will not spit up or cry for hours”. If you are experiencing any difficulties or problems you should find your local IBCLC, this recommendation could be from your pediatrician, OB/GYN, friends or many other places.  Always ask for the credentials of IBCLC as well. We are board certified and we must comply with the rigorous standards of our certification.  

Most importantly enjoy your baby, if for some reason you decide to not breastfeed or are limited to the amount of breastmilk you produce, always hold your baby, always kiss your baby, always nurture your baby.  Your baby needs to be loved and can never be “spoiled” by holding or caring for immediately when he or she cries.  Use your motherly instincts, that wonderful voice in your head telling you what feels right or wrong.  Listen to them, they will never steer you wrong.  

Donna B. Kimick, IBCLC, RLC
Lakeshore Lactation

Why should you use a Lactation Consultant?

Last year, the New York Times published an article about lactation consultant Freda Rosenfeld. A reader responded that the fee charged by lactation consultants is outrageous…depending on where you live, it can cost {$300-400} per session.  It is wise for parents and parents-to-be to understand and evaluate what IBCLCs do and ask “Are IBCLCs worth it?” We come back with a resounding “Yes!”

WHY HIRE AN IBCLC?

Families who seek the help of an IBCLC (International Board Certified Lactation Consultant) get the gurus of breastfeeding knowledge and support. If you had a toothache, you would seek the care and advice of someone who is an expert on teeth, your dentist; if you were concerned about your heart, you’d find the most qualified, expert cardiologist. An IBCLC is an expert on breastfeeding. By finding one as you begin breastfeeding, you equip yourself with the very best support available. A strong support system can significantly help you meet your breastfeeding goals. A good IBCLC can be the key player on your A-Team.

WHAT DO YOU GET FOR YOUR MONEY?

IBCLCs work in a wide variety of places and contexts.  Some work in hospitals just after birth and others research and further the understanding of breastfeeding.  You can also find IBCLCs in organizations that promote maternal/child health and nutrition, such as WIC.  IBCLCs are a varied group in terms of background, areas of specialty, and communication styles, but they stand firm that Babies are Born to Breastfeed.

Many moms, through the course of pregnancy and birth, find that what they need is one-on-one help when they have questions or breastfeeding seems difficult.  Private practice IBCLCs fill this role. A lactation consultant in private practice is self-employed, or she might work in partnership with one or two other IBCLCs.  While $120-$300 seems like a lot for the time required for a consultation, think of it this way:  you get years of study and experience, the full attention of an expert focused on YOU, follow up via email, phone or text, a listening ear, detailed reports for health care providers (putting everyone on the same page for your care), and someone who is required to learn, learn, learn how to support you.  Your IBCLC spends time reading research, connecting with other lactation professionals, and staying up to date on the latest methods, trends, and breastfeeding products.  Adding all that up, it’s a bargain!

ARE THERE ANY IBCLC’S IN MY COMMUNITY?

Hopefully, YES! Many hospitals and organizations that support mothers recognize the expertise board-certified lactation consultants bring.  Asking your health care provider, childbirth educator, and doula about breastfeeding resources in your community can help you beat the Booby Traps!  These people can recommend IBCLCs who want to support your desire to breastfeed.

Unfortunately, some families struggle to find an IBCLC when they need one.  The CDC looks at the number of lactation consultants per capita and has found that we still have far too few IBCLCs to meet the needs of moms. Mothers have long relied on mother-to-mother breastfeeding support groups like La Leche League, which are outstanding when we have questions and seek a community of other new and experienced moms, but sometimes, the eyes and knowledge of a medical professional are necessary.

The training to become an IBCLC is rigorous. It’s a major commitment, just like the training and education any medical professional must acquire.  IBCLCs must demonstrate competence in a wide variety of subjects and in support of breastfeeding mothers and babies, either as volunteers or in paid work. Most, but not all IBCLCs have breastfed babies of their own.

The good news is, with the increased support spurred by the Surgeon General’s recent Call to Action to Support Breastfeeding, access to help should become easier.  Currently, there aren’t enough IBCLCs in every community, but more candidates will soon seek to become the kind of IBCLCs that moms need.

ARE IBCLCS COVERED BY INSURANCE?

Getting reimbursed by insurance for in-home lactation consultations by an IBCLC depends upon the insurance company and plan.  I recently had a call from a mom who said that her insurance would cover a consult, but only with a “preferred provider.”  When we searched the database of preferred providers, the closest IBCLC on her plan was 300 miles away! Some plans cover consults and pump rentals, but there can be numerous barriers to receiving payment.  Unfortunately, many IBCLCs do not pursue insurance plan affiliation because of the difficulty in getting paid.  If a mom would like to submit a claim for insurance reimbursement, she can request a “Superbill” for submission to her insurance company.   It will be prepared by the IBCLC and clearly state the information the insurance company needs.

The fact that support services which augment breastfeeding success rates are not routinely covered by insurance is a huge public health policy concern, one the Surgeon General addressed in her Call to Action.  Ensuring appropriate compensation for IBCLCs as professionals in maternal/infant health care ensures better outcomes for mothers, babies and health care providers. Let your elected officials know if an IBCLC helped you breastfeed your baby, and that you want insurance companies to recognize the professionalism and unique competence of the IBCLC!

ARE IBCLCS WORTH IT?

If an in-home consult with an IBCLC seems expensive, consider its value alongside other things you would spend money on for your baby.  How much did you pay for your stroller?  Your highchair?  Would you be willing to pay that much for expert support? If you are feeling challenged by breastfeeding and considering giving up, consider the cost of NOT seeking professional help: artificial baby milk to feed your baby if donor milk is not available; bottles and the energy required to prepare, heat, store, and clean them;  and the statistically likely increase in healthcare costs for a baby who doesn’t receive breastmilk.  These are among the financial costs of not breastfeeding. While breastfeeding is NORMAL, the risks of not breastfeeding are significant – and expensive!

An IBCLC can be a critical player on your team.  They serve a unique and expert role in detecting and solving breastfeeding problems. Having a community of support in your breastfeeding journey can be invaluable, as well. La Leche League and other breastfeeding support groups will keep you on track and help you stay confident in the biological norm of breastfeeding. For those that qualify, WIC can be another fantastic supporter of breastfeeding.

Having experts on your side while breastfeeding your little one is one of the most valuable things you can do.  Enlisting their knowledge and support can be a win-win both for you and your baby and the community as a whole. You get an expert, an encourager, a detective, a clinician and cheerleader all rolled into one!  Strong support means strong Babes!

Written by Amber McCann, IBCLC “ARE LACTATION CONSULTANTS TOO PRICEY?”