What is a Lactation Consultant?

As I mentioned in my previous post, this month we will be discussing lactation consultants, the different types and how to choose the best fit for your family. A lactation consultant is a specialist in lactation and breastfeeding just like a dentist is a specialist in dental health and a pediatrician specializes in children’s health. Lactation professionals usually fall into three categories: lactation counselor or educator, lactation consultant (LC or CLC) and International Board Certified Lactation Consultant (IBCLC). Some will have different training, a different scope of practice and not all cities will have access to all three types.

Lactation or breastfeeding counselors/educators will go through some training, such as a weekend workshop, that covers breastfeeding basics. There may not be a required test and no hands-on training is provided. A certified lactation consultant (LC or CLC) will have approximately 45 hours of specialized instruction and an exam. Some programs may not require training in a clinical setting. An International Board Certified Lactation Consultant (IBCLC) is required to have at least 90 hours of lactation instruction with 500 to 1000+ clinic hours with a mentor IBCLC. They must also be a licensed healthcare provider or take additional college courses. The final step is a 4-hour exam. IBCLCs are also required to re-certify every five years.

Where do lactation consultants work?
If you choose to birth at a hospital, most will have a lactation consultant on staff and you may have access to them for a specific number of days after giving birth. Some regions offer complimentary lactation support in a group setting, such as the Ontario Early Years Centres. Most cities and towns also have private practices.

How do I find a lactation consultant?
As with most things related to parenting and babies, word-of-mouth may be your best friend! Ask your doctor, your friends or other mothers who they recommend. Otherwise you can find most, if not all, lactation consultants online. While Google might be your first stop, you should also take the time to search accredited associations for listings near you:
https://iblce.org/public-registry
https://www.clca-accl.ca

How do I choose a lactation consultant?
While choosing any type of healthcare provider is a personal choice, here are some things to keep in mind:

  • Which organization did they certify with?
  • What kinds of resources do they use? Are these resources science-based?
  • What is their scope of practice? Are they qualified to counsel you on your particular case?
  • Are they taking the time to listen to you? As the mother, you have every right to be a part of the solution. Don’t be afraid to ask questions or voice your concerns.
  • Depending on your concerns, the lactation consultant should put you on a feeding plan. For example, if it is decided to supplement, your consultant should give you a specific timeline of how to increase your breastfeeding sessions and how to wean from the supplementation with appropriate checkups.
  • Do they promote breastfeeding? Sounds silly, but like any profession there are good and not-so-good consultants out there. If your goal is to exclusively breastfeed, then they should be supporting your choices. Same goes if you are breastfeeding and supplementing. The lactation consultant should be able to provide you with science-based answers and help you towards your goals.

Even if someone recommends a lactation consultant, they may not be the right fit for you. The bottom line is that you need to go with your gut and be able to trust the lactation consultant. If you don’t trust them, find someone else. You know your baby best. If you’re not comfortable with the answers given to you, keep asking questions, or go find another professional.

Lactation consultants are a great resource for parents. Are you interested in learning more about them? Check out Milkology’s breastfeeding myths article here!

Reflections on an Eighth Birthday

We celebrated Little Miss’s 8th birthday this past Sunday. As I am laying in bed with her, I can’t help but be amazed at how much she has grown. Was she ever really so small that she fit in my belly? She holds my hand tightly as she falls asleep and I remember how tiny and wrinkled her newborn hands had been. I remember her birth like it was yesterday.

Early Labour

The morning of October 21st 2010, I went to the midwifery office for a stretch and sweep. I’ll skip the details of that appointment but needless to say on my 10-minute drive home, I was starting to feel some contractions. It’s a wonder I ever made it home! I spent the rest of the day at home, walking around a bit, trying to relax. I can still picture myself snuggling with the cat on the couch. She was laying on my stomach and it was hilarious seeing her rise with my belly every time a contraction began. I had called my husband at work and, after picking up some spicy rotis, he came home in the early afternoon. I didn’t have much of an appetite. I was too busy keeping methodical track of my contractions. Maybe a bit too methodical in hindsight! In the early evening, I called my midwife Mrs. K, and she assessed me over the phone. She told me to call her back once the contractions were closer together. I had my TENS machine strapped on and my husband and I tried to pass the time by watching one of our favourite movies The Love Guru. It was probably around 7 or 8 o’clock when the midwife arrived at our home. After conducting her exam, she informed me that I was fully dilated. Fully dilated?!? That came as a surprise to me! The contractions were nowhere near the pain that I had thought I would experience. And my water hadn’t broken! The midwife gave me two choices: have the baby at home, or get an ambulance to drive us to the hospital. This was our first baby and we had not done any research on home births. We decided to go to the hospital. At some point before the midwife came, I started getting an urge to push. Our childbirth educator M had given us a trick if I was ever in a situation where I felt the urge to push but needed to wait. Say the word “house”. It sounds strange but it works! Kudos to M otherwise I would’ve had my daughter in the ambulance! Once the ambulance had arrived, my husband and Mrs. K helped me into my winter coat and we slowly made our way to the vehicle. I don’t remember much of the drive to the hospital other than Mrs. K holding my hand and me frantically chanting “house, house, house!”.

At the Hospital

The other midwife, Mrs. R, met us at the hospital and we were quickly settled into a room. The hospital bed was tilted up and I was labouring on my hands and knees. But I had no idea what to do – it was my first time birthing a baby. One of the midwives suggested that I start pushing whenever I felt the urge. I pushed tentatively at first, but soon got into a better rhythm. The midwives were lovely, helping me change positions, offering me sips of water. They must have helped in other ways, but the whole event has always been a bit blurry for me. I remember laying on my left side, facing Mrs. R and my husband. Mrs. K was by the foot of the bed. The baby was crowning and Mrs. K held up a mirror so that I could see the baby’s hair. She also encouraged me to touch the baby’s head. I was a bit hesitant, but followed her guidance. And boy, was I ever glad I did! It gave my body the extra energy I needed. My waters still hadn’t broken and Mrs. K had cut the amniotic sac so that Little Miss could take her first breath. I will always remember the moment that her head was birthed. My vision went black, except for a tiny pinprick of lightΒ  in the middle. The next moment, I was looking at Mrs. R who told me that the baby’s head was out and I only needed two small pushes to get the shoulders out. Once the shoulders were out, the intensity and the pain ceased immediately. A wave of maternal love came out just as Little Miss was slipping out of my body. I have never felt an emotion so intensely like that before, and I doubt I ever will again. I was holding her on my chest, kissing her head and completely in love with this tiny person. Even eight years later, I can easily slip into that beautiful memory. Little Miss’s skin was so dark, it looked like she had been tanning in there! She had dark eyes and dark hair, but both would lighten up in the following weeks.

The Golden Hour

The midwives helped me latch her on, Little Miss nursed on and off for a while, she pooped on me, I laughed, still on a birthing high. What a magnificent way to start a life! I was brought a peanut butter sandwich, which I devoured! The routine exams were eventually done with the baby. About three hours after the birth, the midwives said that they were going home and we could too! Our parents were shocked as they were used to the mother and the baby staying in the hospital for at least a day or two. The midwives assured everyone that Little Miss and I were healthy and free to go if we wished. I was glad to be able to go home. I knew we wouldn’t get much sleep, but I’d rather get no sleep at home than in a hospital. Little Miss was so tiny in her infant car seat. I sat in the back with her while my husband drove us home. He was so nervous that I think he drove 20km under the speed limit.

The Next 8 Years

As I lay next to Little Miss, eight years after that night, I am filled with love and awe at how much change can occur in such a short amount of time. In another eight years, she will be 16! I hope our relationship can keep strengthening so that we can share quiet nights together, watching the moon rise out of her bedroom window.