Lactation Consultant Q

[sraplayas]

I'm a BF mama to DS and not currently having any problems, but due to the experiences of friends and family, I am curious about something.

It seems that I have "heard" this scenario too many times:  baby nurses in first 24 hours, baby goes back for 1st apt. and hasn't "progressed" as expected.  The LC offers formula b/c mama does not have "enough" milk.  The mother wants to try and is "given" 24 more hours to see if the weight increases.  The weight is not satisfactory, the mama is told to supplement with formula but also try X natural things, if they want. 

I have, at times, needed to consult with an LC and have gone to a fabulous one that did not have one can of formula in her shop.  I am certain that if I had supply issues and had tried to resolve them without sucess, that she would have been supportive of supplmenting b/c the health of the baby & mama is really the goal, right?

It just seems that there are some out there who aren't as, shall I say, zealous, about helping mamas with, say, supply issues, etc.   

Can someone kindly educate me on this topic so that I can be more helpful to my friends? 

Thanks!

Edited by sraplayas - 3/18/11 at 6:54pm

[ecbrks]

I am an IBCLC ... so my answer will skew as you might expect. 

If you have a friend whose baby isn't "progressing as expected," I would suggest she contact an IBCLC and have a consultation.  She can search for an IBCLC by geographic location at "Find a Lactation Consultant" at www.ilca.org (the professional assn).  Yes -- she will probably have to pay (just like she has to pay to see a dentist or a chiroractor or a massage therapist), but some IBCLCs work with insurance companies ORprovide paperwork to the mom so that the visit (corss fingers) be reimbursed in full or part.

Every mother and baby has to be assessed as an individual couplet.  What does "progress as expected" mean, and who is measuring?  How far along was the baby when it was born; what was the birth like; what medications or interventions were used?  How much have the baby and mother been separated at birth?  Is baby doing any BFg at breast?   Is the baby not feeding because it is heavily swaddled, hands covered, and tucked in the bassinette -- or is the baby not feeding even though it is on mom's chest, skin-to-skin?  What about Mom's [in]fertility and [breast development and surgery] history?  This is just a fraction of the stuff I look at.

There are many, many variables that go into the analysis of whether a baby needs supplementation; if so, what kind.  I have moms doing a lot of hand-expression, and then pumping, to ramp up supply -- I do not reach lightly for formula, and then only with the pediatrician's OK.  If it is appropriate to supplement -- even with expressed breastmilk, there is a discussion of what means (cup, spoon, syringe, tube-at-breast, bottle).

So much of breastfeeding is a confidence game -- and as the US Sureon General said in her recent Call to Action to Support Breastfeeding, eveyrone can play a part in making it easier for a mother. Sometimes mothers simply need an explanation that the baby who is sucking-sucking-sucking isn't *hungry* so much as *enjoying the warmth and safety of mom's arms, with the added attraction of suckling as a comfort measure.* 

One of the very BEST things a mother can have around her is another friend who is a happy breastfeeder, modeling (without even realizing it!) how to meet a baby's needs.  In that department, you are an invaluable resource.

[mojumi]

Hi!  I think you've gotten a great response already.  I wanted to add that anyone can call his or herself an "LC" -- but only an IBCLC (International Board Certified Lactation Consultant) has specific background education and training -- usually *years* of training -- in lactation specific issues and support, and has passed international boards (exam).  So check out your "LC" -- what is her training and experience?

(Of course, there are plenty of fabulous breastfeeding supporters out there -- like La Leche League Leaders -- or good friends who are also breastfeeding -- who can share support and information and hardly need to pass an exam to be crucial parts of your breastfeeding support network!  But you were asking about "LC"s)

This article from Best for Babes might be helpful, too:

http://www.bestforbabes.org/2010/03/hidden-booby-trap-is-your-lactation-specialist-an-imposter/

Good luck, and good for you for doing your research so you can educate yourself and others!

Monique

[sraplayas]

Thank you both for your thoughtful responses.  Though I am far from my dear ones that are struggling with this, I can still insert hope and a greater perspective into conversations that we have over the phone. 

My heart really goes out to all of those that are dealing with some difficulty or other right now and I thank God that I am still able to BF DS as I did with DD.  It is never something to take for granted!

Thanks for what you are doing to further BF awareness and health among women & babies. :)