Are lactation consultants part of the problem?

[elizaMM]

Lactation consultants must be part of the problem. Even IBCLC's?

We have an IBCLC at our local hospital and yet half the mamas I know who birthed there "didn't have enough milk"! I know she is handing out nipple shields and formula (the former I think might be an acceptable last resort?) but why???

The local WIC nutritionist said "Our initiation rates are GREAT. But it seems like only the hispanic women can supplement without effecting supply." (what??!!)

Does the IBCLC certification process need to be improved?

Would this be a good lactivist statement to drop at every opportunity: "Don't listen to any lactation consultant who tells you that some women just can't make enough milk. (A VERY SMALL number can't, but most, with propper support, can make enough for TWINS!)"

Or maybe a mega-bumper sticker: "Women who 'couldn't make enough milk' probably didn't have enough support. SUPPORT BREASTFEEDING MAMAS!"?

Thanks y'all.

[Lil'M]

Did these mamas you know say that the lactation consultant told them that? If a hospital has only one IBCLC, it is possible that they never even saw her. One hospital near me has only one IBCLC and she works exclusively with the NICU. Everybody else deals with nurses with varying degrees of bf education/misinformation.

It wasn't clear from your post how these mamas decide that they don't have enough milk. It would be interesting to see where they got that idea.

[scraphappy-Red]

Wouldn't it be easy if we could just pin this problem on one specific group of people? Sometimes I feel that way with the support that some mamas in my community receive from our hospital.

But I don't think it's really the case. IBCLCs (who must pass a very rigorous exam to be real IBCLCs) are only human too. I can't remember how many times I've heard someone here complain about bad advice/bad behavior of an LLL Leader. Does that mean that all LLL Leaders are bad? Gosh, I hope not! And as you are hearing, maybe you have a local IBCLC who is not doing her job in the best way possible, but does that mean all IBCLCs are bad? We'd better hope not!

We're all only human, and we all make mistakes. Is there some way you can get more involved with the IBCLC on a professional/volunteer basis...with a common ground of both of you being lactation activists, and see if what you're hearing is true?

I think that sometimes IBCLCs (and LLL Leaders) make mistakes, but the true culprit in this whole mess are formula companies and unrestrained advertising practices. We are all victims of that behavior!

[RoadWorkAhead]

I think there are a few select IBCLCs and LCs that need to be reported. IBCLCs can be reported to their licensing agency. I dealt with an IBCLC who is AWFUL. She has purposefully thwarted many a breastfeeding relationships and tried with me (DS1)...SHe is exclusively based in the NICU and tells moms any number of falsehoods. At the time I didn't know I could report her to the the cert. board so I just made sure the hospital knew that she was terrible, but now I tell people to complain to the cert. board when I hear about her antics. She's told people that they'll not bring in milk with a preemie w/o giving them a chance, that ou can't BF twins, that you can't BF after reduction *Some can't but some, like me, can BF twins*, that its not worth trying with a preemie/twins.... She's definitely a part of the problem, but I think she is more of an exception than the rule.

[elizaMM]

Lil'M, you have a good point. They may have concluded that they didn't have enough milk on their own.

I'm really not trying to blame it all on IBCLCs. I know that there are a lot of other contributions to the problem I just wondered if LCs are *part* of it. I have only met one (who was great! she saved us!). And only heard about this one other. I don't know how else to learn about this stuff except from you all. And I have heard some here say that even IBCLCs can be misguided. So I"m just wondering...

Red-that's a good suggestion-- to volunteer with the local IBCLC. Sometimes I let my disagreement get in the way of acting normal. Too often, in fact. I forget that there alternatives to responding "you're wrong" so I just keep my mouth shut. I'm working on it.

What are thoughts about my proposed lactivist statements?

[puddle]

As far as the nipple shield thing, an IBCLC that I know explained that part. She said she met some hospital IBCLCs and they basically do whatever it takes to get a mama to leave the hospital breastfeeding, even if they know the nipple shield will cause problems later. Breastfeeding with problems is better than giving up before they even get discharged.

Also, some people manage to hear whatever they want to no matter what is actually said. An LC who says "If you nurse on demand day and night then you will have plenty of milk" could be heard as saying "If you would rather feed on a schedule, then you'll need to supplement" if that's what the mother is looking to hear.

As far as the lactivist sayings, the first one sounds too negative. The second one isn't bad.

[justthinkn]

Originally Posted by elizaMM

Or maybe a mega-bumper sticker: "Women who 'couldn't make enough milk' probably didn't have enough support. SUPPORT BREASTFEEDING MAMAS!"?

As one of the small percentage who had AMAZING support, but less than stellar mammary tissue - still nursing b/c of that support at 19mo's - can I offer this edit?

"Most women who 'couldn't make enough milk' really didn't have enough support. SUPPORT BREASTFEEDING MAMAS!"

Can't explain why, but that makes me cringe less. All I can tell you is that it was very difficult for me when people would assume or even just imply that things would be different for me if I had had more support or known X, Y and Z.

[SallyN]

I think there are so.many other more significant "parts of the problem" that targeting IBCLCs is low on the priority list.

But... I will very much agree that not all IBCLCs are created equal. I'm fortunate to live in an area with a multitude of IBCLCs, and through my volunteer work with our local API group and our regional Breastfeeding Task Force, I've gotten to know a fair bit about them. There are some that I'll refer for certain degrees of bf challenges, but for 'major' challenges, there's very much one stellar "go to" IBCLC.

The process to obtain IBCLC certification is long, arduous, and the path each person takes can be highly variable - this is what leads to such differences in qualification and experience. An IBCLC who started as a NICU RN is going to have a very different approach/experience than an IBCLC who started as an inspired breastfeeding mom. Honestly, I'd hate to see the process be made any more complicated/longer.

Where I DO think attention could be focused upon, is CLC or even the plain "LC" training/requirements.

[Ruthla]

There's only ONE IBLC at your local hospital? Chances are that she's overworked, doesnt' get to meet with every single mama who births there, and doesn't spend more than a few minutes with many of the moms she DOES get to see.

I've never really heard of a mom being told she 'doesn't have enough milk" in the first few days- yes, it can happen, EBF newborns can get dangerously dehydrated, but that's the exception, not the rule. "Insufficient milk supply" is far more likely to be diagnosed by the pediatrician a few weeks or months later, when he or she isn't happy with the baby's growth rate.

Unless the mama goes back to the IBLC and then gets bad advice, you can't blame the IBLC in those situations! Many peds might say "the baby isn't growing fast enough, here's some formula to supplement with" rather than giving advice on increasing breastmilk and/or referring a mom to somebody else for breastfeeding help.

[kriket]

Originally Posted by justthinkn

"Most women who 'couldn't make enough milk' really didn't have enough support. SUPPORT BREASTFEEDING MAMAS!"

I love this!

I wouldn't blame the LCs I would blame the mamas. (warning I'm probably being bitter)
I have seen that most women seem to want to find a reason that exempts them from BFing. : I was in a class where a woman asked if diabetics could BF, the teacher explained very well that they could but to talk to your DR about meds (turns out she JUST got results back about GD) So after her yes answer, instead of saying "ok excellent, I was concerned" she said "what about pain meds? I would like to have Vicodine after birth" The lady explained that. Then "what about if you have small breasts?" the lady explained that.

This was this womans 3rd child.

Other women in the class said "Oh well I just can't I tried with my 1st and it just didn't work out for me." The LC asked her what kind of support she had and the woman basically responded "all kinds, nothing will work for me, I'm a lost cause"

Sooooo..... If you don't want to BF, fine, I don't care. (to the hypothetical mamas that manage to cross my path and say these things.) DO NOT try and tell me that I can't, or will have problems or whatever. I plan on blissfully feeding my baby until they are way too old. If you have a problem with it keep it to yourself. If you just have to say something to me, be prepared for me to rip into you about FF. Its only fair.

And thats how I feel. Thanks for listening

[Siera]

I think this is an interesting post. I know when it comes to the LC's at the hospital where I gave birth, the three that work there definitely fit this description. Friends who had full-term babies at my hospital were frequently told by one LC in particular there that either they didn't make enough milk or their baby wasn't a good breastfeeder! My DD was a preemie, and I believe I was given information that just wasn't correct, like preemies can't' nurse well (DD nursed way better than she ever took a bottle, all they had to do was watch her/weigh her) or that there is no such thing as nipple confusion (???!??!) -- these are just two examples. I had to hire my own LC once we got out of the hospital and she helped us immensely. So, I definitely agree that some are not helping.

[Kappa]

Most women I know figure that don't "have enough milk" when cluster feeding starts and the baby wants to feed more often than every X hours. There needs to be some one there to name that behavior, tell the mother why the baby needs to feed that way, and tell her it is normal and expected.

And with the nipple shield thing, I was offered a shield 2 times by a nurse and a pediatrician and I never used or needed one. The shield is a conundrum, don't know if it can be solved.

[homewithtwinsmama]

Ugh, my answer is unequivocally yes. I had a mama who birthed Tuesday and the lactation consultant handed her breast shields after just a few hours after birth. Her nipples were flat and baby wouldn't latch. So maybe bring her a breastpump to help draw them out, breast SHELLS which are designed to draw them out. Fortunately she realized quick this was NOT working and called me. I teach CBE. I had flat nipples with my twins so I have experience with them. Can I just say, I don't get the infatuation of all our area LCs with the d*** nipple shields. Seriously they hand them out like candy here.:

[2lilsweetfoxes]

Originally Posted by Kappa

Most women I know figure that don't "have enough milk" when cluster feeding starts and the baby wants to feed more often than every X hours. There needs to be some one there to name that behavior, tell the mother why the baby needs to feed that way, and tell her it is normal and expected.

Had I not researched before my DD was born, when she started cluster feeding and having a growth spurt (fun times, fun times), I would probably have given up figuring I did not make enough milk. I still remember that night--DD had been on the breast all evening, but was not satisfied. Now, it was 2 am and she was up again for the fifth time since we went to bed at 10. I hear someone moving about, then DH came into the room holding a bottle of formula insisting that I go to bed and he'd take over. Sleep deprived with a child that couldn't get enough to eat, I went to bed and let him feed her. She slept pretty much until morning. I then did a bit more research and decided no more bottles and got rid of them and the formula.

Had I given up with her, I doubt I would have even tried with her brother.

I think the biggest problem is that we make breastfeeding sound all rosy and easy, so if you run up against something that is normal or a minor, easily resolved, problem, you think you can't do it or bottles are easier and give up. I think a lot of women give up during these growth spurts.

[leosmommy]

http://www.makestickers.com

I'd love to see "Most mamas who 'didn't have enough milk' really didn't have enough support. SUPPORT BREASTFEEDING MAMAS" on someone's car!

prices start at $4.95 for 1 bumper sticker. you can change the color if you'd like.

this isn't my website...I just love it because you can make any bumper sticker you want for under $5 bucks.

I'd make one for myself but we can't afford it right now, money is very tight.

[Kappa]

Originally Posted by 2lilsweetfoxes

Had I not researched before my DD was born, when she started cluster feeding and having a growth spurt (fun times, fun times), I would probably have given up figuring I did not make enough milk. I still remember that night--DD had been on the breast all evening, but was not satisfied. Now, it was 2 am and she was up again for the fifth time since we went to bed at 10. I hear someone moving about, then DH came into the room holding a bottle of formula insisting that I go to bed and he'd take over. Sleep deprived with a child that couldn't get enough to eat, I went to bed and let him feed her. She slept pretty much until morning. I then did a bit more research and decided no more bottles and got rid of them and the formula.

Had I given up with her, I doubt I would have even tried with her brother.

I think the biggest problem is that we make breastfeeding sound all rosy and easy, so if you run up against something that is normal or a minor, easily resolved, problem, you think you can't do it or bottles are easier and give up. I think a lot of women give up during these growth spurts.

S

So, would it have helped if you had an LC call you around the 2 weeks mark and say:
1) Has cluster feeding started?
2) If not, it will start w/i a few days.
3) It will seem as if the baby is constantly hungry and s/he will need to nurse more often than every X hours.
4) Do not worry, this is normal.
5) It accomodates the baby's growth spurt, and increases your supply so that you may be able to meet your baby's needs in the next few weeks.
6) If you have X wet diapers and regular BMs, then you have enough milk.
7) Do not supplement.
8) Call me if you have any more questions.

I think this could help most people

[veganone]

I do think they can be part of the problem. The first TWO LC's I saw were not helpful at all. The third was amazing and I am thankfully still bfing my 16 month old.

Partly it was the hospital, the LC didn't even see me until day 4 with a pre-term baby who never latched in all 4 days. (All three were through the same hospital, and all three told me completely different things.)

But after that, they offered inconsistent and not very helpful advice. I do with there was a better training process for certification. DD needed a great deal more time on the breast and a lot less time with me triple feeding. If I had known that I could have saved both of us a huge amount of stress and sleeplessness. Instead, I was told consistently to keep pumping for DD since she was so hungry rather than letting her cluster feed like she was trying to do!

I'm amazed I made it through without quiting.

[ameliabedelia]

I think that like any profession there are good LC's and IBCLC's and bad ones. I do think that the way one comes into that profession might make a difference in their approach to helping mothers. A LC or IBCLC who started down that path because she became passionate about breastfeeding after breastfeeding her own child/ren (maybe starting down the path as LLL leader or CLC first) is going to be coming from a different place than one that came from a RN or other medical background and simply took the exam as another credential to have or to fill a need at a hospital where she worked.

I think that *some* LC or IBCLC that are from a medical background (RN, etc.) *might* be more "medically-minded" and tend to see problems and then hand out solutions (ie, see cracked nipples, hand-out nipples shield or see low weight gain/poor milk transfer....hand out pump or supplement, etc.).

I also think that if one views breastfeeding solely as nutrition, vs. a more holistic view, it makes a difference in their approach to helping mothers.

[veganone]

Originally Posted by ameliabedelia

I think that like any profession there are good LC's and IBCLC's and bad ones. I do think that the way one comes into that profession might make a difference in their approach to helping mothers. A LC or IBCLC who started down that path because she became passionate about breastfeeding after breastfeeding her own child/ren (maybe starting down the path as LLL leader or CLC first) is going to be coming from a different place than one that came from a RN or other medical background and simply took the exam as another credential to have or to fill a need at a hospital where she worked.

I think that *some* LC or IBCLC that are from a medical background (RN, etc.) *might* be more "medically-minded" and tend to see problems and then hand out solutions (ie, see cracked nipples, hand-out nipples shield or see low weight gain/poor milk transfer....hand out pump or supplement, etc.).

I also think that if one views breastfeeding solely as nutrition, vs. a more holistic view, it makes a difference in their approach to helping mothers.

Good point. ITA.

[2lilsweetfoxes]

Originally Posted by Kappa

S

So, would it have helped if you had an LC call you around the 2 weeks mark and say:
1) Has cluster feeding started?
2) If not, it will start w/i a few days.
3) It will seem as if the baby is constantly hungry and s/he will need to nurse more often than every X hours.
4) Do not worry, this is normal.
5) It accomodates the baby's growth spurt, and increases your supply so that you may be able to meet your baby's needs in the next few weeks.
6) If you have X wet diapers and regular BMs, then you have enough milk.
7) Do not supplement.
8) Call me if you have any more questions.

I think this could help most people

: And also call at the other common growth-spurt times (with knowledge of if the baby came early or late). I did make it through and weaned her at a year and a half.

One thing I worry about with this new baby is that I have to go back to work at 6 weeks. That coincides with a growth spurt. I'm going to try to induce oversupply before returning to work, though...