What Do Lactation Consultants Really Do?
The majority of my work as an IBCLC (international board certified lactation consultant) is education. The more we can arm a family with information, the better. As an IBCLC, I am an expert in lactation support and care of the breastfeeding family. However, you are the expert on your family and there is no amount of clinical information that can replace how parents know their children.
Over the course of my medical career, no matter the field I am currently working, my goal for each encounter is informed consent. I have the information, I give the information, you make the decisions. When it comes to pregnancy and infant care, it is critical that families are able to review all risks and benefits. After that, it’s just as crucial that they be given space to make the best choice for their family. In the spirit of furthering informed families, let’s start breaking down the false information out there that is creating confusion.
Myth #1: Lactation consultants hate formula!
IBCLC Rule #1: Feed the baby.
Breastfeeding is a beautiful thing. When the infant latches well and the milk supply is there to meet the nutritional needs some wonderful things happen. Hormones flow and the baby feels secure and comforted. On the maternal side the brain and breasts work to regulate just the right amount of milk. Oxytocin helps to tone the uterus. Primitive reflexes aid the infant in seeking and attaching to the breast. Cues from the infant and hormones from the release of the placenta signal the release of nutrition that matches the newborn’s needs perfectly.
It’s a sweet picture. I’m getting the warm fuzzies just thinking about it right now. However, my profession would not exist if that happened each and every time. Sometimes there is a separation after birth because a medical emergency occurs. Infant oral issues abound: cleft lip, cleft palate, poor suck, tethered oral tissues (“tongue ties,” etc). Retained placenta can inhibit the release of that precious first milk. Between the breast and the baby’s stomach a lot can happen.
Feed The Baby
So what is the first step? FEED THE BABY. The situation will determine how this happens. Let’s say that the issue is related to difficulty in latching to the breast during the first day of life. We would work on hand expressing colostrum and giving that to baby as a cup feeding, spoon feeding, or syringe feeding. What if there isn’t enough colostrum? In that case, formula can be given by cup, spoon, or syringe. If the baby is unable to suck and swallow? Then colostrum and/or formula can be given through a tube that goes into the baby’ stomach (gavage). While bottle feeding can be an alternative, we often try to avoid that. No matter how slow-flow the nipple, there is still always a passive flow from a bottle nipple. When the goal is to get the baby back to the breast, it’s best to avoid getting a baby acclimated to a bottle nipple. Click here to read more about “nipple confusion.”
What if the family just does not feel that breastfeeding is the right choice for them? Sometimes people believe that they need to formula feed due to a medical or situational issue. In this case, we can discuss the “why.” Many times families are relieved to know that their daily medications are actually safe for breastfeeding, or that their body is capable of making enough milk to feed twins. If that is the case, lactation consultants are there to help figure out the “how.”
And if a family knows the risks and benefits and simply does not want to feed with breast milk? Then that is their choice!
Lactation consultants choose our profession because we love to help families. When a family has been given objective education and makes an informed decision, we are doing our job. We don’t hate formula. It’s a valuable tool and we’re thankful that it is available. IBCLCs are considered the “gold standard” because of the extensive education and testing required. What this means in reality is that we tend to see some complicated and challenging cases. Formula is a necessary tool in many of these cases! There is absolutely no shame in needing to use formula to ensure that your baby is getting sufficient nutrition. A malnourished baby does not latch well.
The Top Up Trap
What we want to avoid is the unnecessary use of supplements. If breastfeeding is actually going well then adding in supplements can cause problems. Baby will lose interest in nursing as frequently and then the supply really will decrease. Those are the cases where we want to avoid the supplements and intervene with support. If you suspect you have a low milk supply, talk to a lactation consultant ASAP.
What Should I Do if I Think I’m Not Making Enough Milk?
The first thing we need to do in this situation is to think back over the last twenty-four hours. Has baby eaten 8 or more times? Are the wet and dirty diapers happening? Take a look at some ways to tell if your baby is getting enough milk.
If you’re concerned, get support! Reach out to an IBCLC and talk about what is going on, we’re here for just this reason.
Amanda is an RN, IBCLC (lactation consultant) who helps breastfeeding families through classes and home visits in the greater Baton Rouge, La area. Secure virtual visits are available for breastfeeding support no matter the location.
All information on this website is intended for educational purposes only and should not be construed as medical advice. Magnolia Lactation Consulting encourages all families to have close communication with the medical providers of their choice.