Breastfeeding specialists

Where can I get extra help with breastfeeding?

There are a variety of breastfeeding specialists who can provide extra breastfeeding healthcare. These specialists may be doctors, nurses, midwives, or lactation consultants and they have a variety of skills and experience. Lactation consultants are certified by an international organization and are required to pass regular examinations and meet standards. Breastfeeding counsellors can provide education and support on basic breastfeeding issues.

A) Describing breastfeeding specialists

Breastfeeding specialists can be doctors, nurses, lactation consultants, or breastfeeding counsellors. Their services may be funded by your health-care system, covered by insurance plans, or available privately. Breastfeeding specialists work with your regular health-care providers and give additional care and support. 

In the United States, mothers breastfed for 10% longer after changes in health policy that required health insurance companies to cover the cost of lactation support services and access to breastfeeding equipment, a review of national data found (Gurley-Calvez 2018). It also found a 21% increase in the duration of exclusive breastfeeding.

Like any group of people, breastfeeding specialists have a variety of skills and experience. Ask what certifications, credentials, and experience a specialist has. If your situation is not improving, if you are not comfortable with the advice you receive, or you feel you are being pushed to buy products, you may want to get help elsewhere. 

B) Lactation consultants

Health-care providers with the International Board Certified Lactation Consultant designation (IBCLC) are called (international) board certified lactation consultants. This is sometimes shortened to lactation consultant, but this term is generic and can be used by anyone.   

Board certified lactation consultants have special training in breastfeeding and have passed an examination run by the International Board of Lactation Consultant Examiners, an independent global authority that sets the standards for knowledge of practitioners in lactation and breastfeeding care.  

There are several pathways to certification. For example, one pathway requires that candidates meet each of the following criteria:

  • Have 90 hours of lactation-specific education, and;
  • Have college-level health science courses or are recognized health-care providers such as nurses, and;
  • Have up to 1000 hours of caring for breastfeeding families.

Board certified lactation consultants must re-certify regularly and engage in continuing education in order to keep their designation.

They may work in various settings:

  • Healthcare institutions
  • Publicly funded health clinics
  • Doctors’ offices
  • Independently in their own clinics

They may join international member associations such as the International Lactation Consultant Association (ILCA), the European Lactation Consultants Alliance (ELACTA), or national ones such as the Canadian Lactation Consultant Association (CLCA).

Most studies have found that mothers who use a lactation consultant are more likely to breastfeed exclusively and longer (Chetwynd 2019; Gray 2020; McFadden 2017).

C) Other breastfeeding specialists

1) Doctors

Doctors such as family doctors, obstetricians, paediatricians, and surgeons can have a special interest in breastfeeding and some have the designation IBCLC.

These individuals may provide care in breastfeeding clinics or in hospital settings. They are able to diagnose, treat, prescribe, and possibly perform surgical procedures if needed. They can be of great help for complex breastfeeding challenges.

2) Midwives

Midwives are expected to thorough knowledge about breastfeeding and may have the IBCLC designation. The types of treatment they can offer and their ability to prescribe can vary between countries.

3) Public Health Nurses or Nurse Visitors

Public health nurses who work with mothers and babies usually have a special interest in breastfeeding and may have the IBCLC designation.

D) Breastfeeding counsellors, advisers, etc.

The World Health Organization created a 40-hour breastfeeding counsellor course in 1993 (WHO/UNICEF 1993). Other organizations have adapted this model. The requirements for becoming a breastfeeding counsellor are significantly less than those for becoming a board certified lactation consultant.

People who use the title breastfeeding or lactation counsellor, adviser, or educator or the generic lactation consultant can have varying degrees of expertise, education, and training. Certification is available for some programs.

Individuals are often women who have breastfed and wish to support others.

They may volunteer their time, have paid positions within health-care systems, or work privately.

They provide education and support on basic breastfeeding issues. They are not qualified to give medical advice, diagnose, or prescribe medication.

References

Chetwynd EM, Wasser HM, Poole C. Breastfeeding Support Interventions by International Board Certified Lactation Consultants: A Systemic Review and Meta-Analysis. J Hum Lact. 2019 Jun 17:890334419851482

Gray KD, Hannon EA, Erickson E, et al. Influence of Early Lactation Assistance on Inpatient Exclusive Breastfeeding Rates. J Hum Lact. 2020 Sep 14:890334420957967

Gurley-Calvez T, Bullinger L, Kapinos KA. Effect of the Affordable Care Act on Breastfeeding Outcomes. Am J Public Health. 2018 Feb;108(2):277-283
 
McFadden A, Gavine A, Renfrew MJ, et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev. 2017 Feb 28;2:CD001141
 
World Health Organization, UNICEF (WHO/UNIFCF). Breastfeeding counselling: a training course.. Geneva: World Health Organization; 1993 WHO/CDR/93.3-5