WHEN TO CALL A CERTIFIED LACTATION CONSULTANT

What is a Lactation Consultant?

Women find it helpful to know how the lactation consultant functions as an integral part of the health care team. Certified lactation consultants are allied health care professionals who come from a variety of backgrounds. They are required to have a thorough working knowledge of a wide variety of scientific disciplines. To be a Certified Lactation Consultant one is required to have many hours of clinical experience and to successfully pass the comprehensive examination administered by the International Board of Certified Lactation Consultant Examiners. Recertification is required at 5 year intervals.

How does a Lactation Consultant help?

Lactation Consultants work in varied settings such as hospitals, clinics, private doctor offices or private practice. The certified lactation consultant is an expert in Lactation and Breastfeeding management. The LC role is to enable and empower women to achieve their breastfeeding goals . LCs work to assist families to prevent and overcome difficulties . Certified lactation consultants collaborate with the other members of the health care team and have the knowledge, skill and expertise to work with mothers and their infants in both routine and special circumstances.

A wide range of services are available depending upon the setting in which the LC works. Serivces can include prenatal consultations, breastfeeding classes, private individual consultations for routine or specific concerns, support groups and availability of breastfeeding pumps, equipment and supplies.

In consultations, most lactation consultants follow a step by step approach beginning with identifying and clarifying the mother's stated goals and detailing the concerns which the mother has. Once goals are established, LC's use their vast array of assessment skills to determine the reasons for the difficulties. Once the assessment is made the LC then explains why the problem is occurring and offers options for resolving it. The LC together with the mother then develop an individualized care plan to address the issues of concern. Instructions for the interventions of the plan are provided, demonstrated, trialed and practiced. Mother is followed by phone and or follow up visits until all concerns have been resolved and mother feels she is independently confident on her own.

But isn't Breastfeeding natural?

Yes it is. So, you might think, why would a woman need an expert to be able to successfully breastfeed? The answer is, that while it is absolutely true that breastfeeding is natural, it is a learned art. That is to say women have always needed a source of information and instruction about how breastfeeding works, what to do and how to do it. Historically, that role was commonly filled by the older and knowledgeable women in their cultures. Women typically learned about breastfeeding from their mothers, sisters, aunts and grandmothers. Midwives tended births and routinely assisted mothers to begin breastfeeding right from the start. Additionally, there was always a "wise woman" to turn to when all the usual sources of information could not resolve concerns. In our busy modern cultures ,when it comes to breastfeeding issues, lactation consultants have taken on the role of both the " culturally experienced family and care givers" as well as " the wise woman".

Suggested Guidelines for Calling a Certified Lactation Consultant

Mothers often recognize that a problem exists but do not know who in the health care team is the appropriate professional to call. Lactation consultants help women before baby is born when they make their decisons on how to feed their baby, help after the baby is born to get started on the right track right from the beginning and to continue breastfeeding if there are common concerns or return to work issues. In all cases the sooner the issue is identified the easier and faster it is resolved. For those situations which can be addressed prenatally, problems are often prevented and or minimized. Overall, the vast majority of problems which mothers encounter are temporary and RESOLVABLE . See below for a comprehensive list of suggested guidelines on just when to call the Certified Lactation Consultant.

Maternal Indicators

History of breast surgery History of previous personal or familial lactation failure Acute illness, chronic illness or handicap Minimal/No breast changes during pregnancy and/or by 1st week after birth Marked breast or nipple asymmetry Breast or nipple pain and/or trauma Acute engorgement Maternal anxiety related to breastfeeding Adolescent or woman having her first child older than 40 years old Current necessity for medication re: chronic or acute illness Relactation or induced lactation

Infant Indicators

History of no latch on within 24 hours of life History of persistent latch on difficulty No audible swallowing note by 24 hours of age Dissatisfied after feed as evidenced by crying, finger sucking, rooting Inadequate stool output defined as less than 2-3 stools, per 24 hours, by day 2-3 Inadequate urine output defined as less than 2 voids, per 24 hours, by day 2; 6-8 voids by day 6-7 Handicapped infants, LBW infants, premature infants, Failure to feed at least 8X per 24 hrs, in the 1st week Infants fretful at breast: squirming, crying, pulling, coming off breast Inadequate weight gain; (minimum wt. gain of 1/2 to 1 oz. per day) Infant weight loss>5% within 24 hours or 10% total weight loss Infant receiving pumped breastmilk

How Do I Choose A Certified Lactation Consultant?

There are a number of important element's to consider when choosing which consultant is best for you. Those considerations are:

Lactation Consultant Credentials: Is the person an International Board Certified Lactation Consultant (IBCLC)? How long have they been certified? Is their certification current? Other Health Care Credential: What other health care field have they received formal eduction in? For example, many nurses and physicians are also IBCLC's Experience and Length of time in the field: How many years have they been working in the field? Inquire as to the average number of clients helped per year; does the LC have a specialty? Where do her referrals generally come from? References: Ask for references from both parents and professionals Costs: Inquire as to services, their costs and method of delivery

How Do I Find A Certified Lactation Consultant?

Telephone Check our online "Resource Guide" @ LILCA.ORG - Under "Find a Lactation Consultant" Call your Midwife, Pediatrician or Obstetrician. Often these health care providers have an ongoing relationship with a local Lactation Consultant Call your local hospital newborn nursery or lactation consultant office. They too have lists of LC's in the community Call the Breastfeeding National Network @ 1-800-TELL YOU ( 1-800- 835-5968)

Online Contact the International Lactation Consultant Association @ www.ilca.org click " find a lactation consultant in your area" On line contact Breastfeeding information website @ Breastfeeding.com click Locate an LC On line contact Medela Breastfeeding National Network @ medela.com/new/newfiles/bnn.html click BNN locate products and breastfeeding specialists On line contact the Internationl Board of Certified Lactation Consultant Examiners @ iblce.org click US Regional Registry

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