How to Find the Best IBCLC For Your Needs
This article was written in collaboration with my colleague, Lyla Wolfenstein, BS, IBCLC. Lyla is a lactation consultant and clinical instructor at Birthingway Breastfeeding Center in Portland, OR.
In an ideal world, every mother-baby dyad would have access to thorough, accurate, compassionate lactation support, from the prenatal period through weaning. Sadly, this is not the case, and sometimes the “support” new families receive is fraught with error – informed by poor (or no) training.
When initiating breastfeeding, it’s difficult to determine which of the overwhelming number of voices are offering sound advice. Everyone from your pediatrician to your sister, your doula, and even strangers from facebook seems to have “the answer.” But are these suggestions tailored to your situation? Do they come after years of intense study? Or are they unwittingly advising actions that helped someone, but might undermine your specific breastfeeding relationship?
We recommend finding lactation help from a professional who meets some basic standards of education and experience.
Here are a few guidelines that can help you select the right match for your situation.
1) Look for an IBCLC (International Board Certified Lactation Consultant). There is no other certification that comes close. The IBCLC requires thousands of hours of direct contact with mothers and babies, specifically helping with breastfeeding. It also requires extensive study of anatomy and physiology, child development, and numerous other components critical for lactation management. The IBCLC is a “stand alone” certification. That simply means that no other license or certification is needed in order to be an IBCLC. You might also see the designation RLC – all IBCLCs are also RLC (registered lactation consultants). Only IBCLCs can use the designation RLC.
You may come across professionals who call themselves “lactation specialists,” “certified lactation educators,” or even “certified lactation counselors.” Those individuals have taken coursework in lactation, but it usually is about 40-90 hours in length—not nearly enough to cover all of the complexities of human lactation.
Just as one would choose a doctor rather than a medic for a thorough medical exam and treatment, or would choose a midwife rather than a childbirth educator to help you with childbirth, so differentiates the IBCLC from other “certifications” that require only a 5 day course of instruction. To ensure your lactation consultant is indeed an IBCLC, you can check www.iblce.org. Although IBCLC is the gold standard for certification, just as in any profession, there are some practitioners who are more skilled than others. Select your lactation consultant wisely.
2) Consider an IBCLC who works outside the purview of a hospital-based lactation center. While many hospital IBCLCs are wonderful, even the best are often constrained by hospital policies. Appointments are usually restricted to an hour or less, so they cannot offer the degree of attention or give the same advice that independent IBCLCs may be able to provide.
3) Ask for referrals from local parenting internet groups, new mother support groups, La Leche League, your healthcare provider, friends and neighbors.
4) Visit websites of various lactation consultants in your area. You can get to know a lot about her level of experience and her philosophy with a few clicks. If you don’t find what you’re looking for—call her and ask for more information.
5) Interview potential IBCLCs before you decide who is the best fit. Call around and ask a few pertinent questions. Check out the website first so you have some background. The IBCLC should welcome your questions. But remember: she is trying to run a business and most LC’s in private practice don’t have office help. So keep the interview brief. Some questions might include:
General questions (you may be able to find the answers on her website):
- How long have you been certified as an IBCLC?
- Do you have any areas of specialty or expertise?
- How long are your consultations? (1.5 hours should be the minimum length for an initial postpartum consultation, and an hour for a prenatal).
- What is your opinion of / experience with bottle feeding?
- With approaches that support breastfeeding?
- With tongue tie and lip tie?
- With body work / craniosacral therapy for newborns?
- With nipple pain in the early weeks – and how do you assess for causes?
- With high-need babies?
- With low milk supply and/or slow weight gain?
The right answer to all of these is something along the lines of, “These issues need to be remedied as soon as possible after the birth, and I am skilled at assessing, addressing and referring in order to do so.”
Ask questions about her level of experience with any particular area you are concerned with, like prematurity, twins or multiples, low milk supply and supplementation.
If you hear anything that makes it sounds like your concerns are not taken seriously, or not worth addressing, or not real, or the IBCLC is lacking in experience in these areas, that’s a red flag!
After learning the answers to these questions, you will be better equipped to select an IBCLC who reflects your understanding and seems experienced in these very important knowledge areas. You will also have a feel for the personality match and can opt for someone who helps you feel confident.
Now that you have selected your IBCLC, you are on the road to addressing and remedying your breastfeeding challenges.