Support Group or IBCLC: What's the Difference?

When a mom is looking for breastfeeding assistance, it can often be difficult to know where to get this help and from whom.  There are so many options…. Facebook, breastfeeding support groups, lactation consultants… where to go can be confusing, especially if she feels like she needs to get help immediately!

So, what is the difference between the breastfeeding help you will get at a support group and at a private lactation consultant visit?

What you can expect at a breastfeeding support group:

Let me preface this by saying that not all groups are the same and it really depends on the level of expertise of the person running the group and how busy the group is.  There are different levels of experience and training in the field of lactation, depending on how many hours a person has spent in class and in an internship.  The level of expertise are demonstrated by the letters that follow the person’s name (IBCLC, CLC, CLE, etc), which is all explained in this fantastic article, What’s the Difference Between LC, IBCLC, CLE, etc?

At a breastfeeding support group, you will find a leader who is there to offer general breastfeeding assistance and support.  This leader can assist with positioning and latch (although often times this leader will not be able to actually touch you or the baby), basic information about normal breastfeeding/pumping strategies, normal baby feeding patterns, normal baby weight gain, breast and nipple care, and ways to maintain and protect your milk supply.  Often times there is a scale where you can weigh your baby before and after a feeding to see how much your baby is taking in (which is AWESOME!)  Attendance at the support group can range from a few moms to over 20, depending on how big the space is and how well attended the group is.  Support groups are often free, depending on where you live.  Support groups are fantastic for getting basic breastfeeding support, getting help while you wait for an appointment with an IBCLC, meeting other breastfeeding moms in your community, and practicing breastfeeding outside of your home.  

What you will not receive at most breastfeeding support groups is a personalized plan of care for difficult breastfeeding situations.  To create a personalized plan of care, a mother and baby’s medical history need to be discussed, as well as mom and baby both need to be assessed, which requires a consent form.  Therefore, most advice given at a breastfeeding support group is general, not specific for mom and baby’s personal situation.  

What you can expect at a private lactation consultant visit:

If you are meeting with an International Board Certified Lactation Consultant (IBCLC), you are now moving from general advice to a personalized assessment and plan of care.  The IBCLC should conduct a suck assessment on your baby, collect medical histories of both you and your baby, assess a feeding session, and offer guidance on how to improve your personal breastfeeding experience.  

Reasons you would want to see an IBCLC rather than just attend a support group:

• Cracked, bleeding nipples

• Painful latching that isn’t improved with positional changes

• Baby not gaining weight well

• Mom’s milk has not come in by day 3-5

• You suspect your baby has a tongue tie and/or lip tie

• Baby has signs of colic or reflux

• Mom has a low milk supply/supplementing baby

• Mom has an oversupply

• Premature baby

• Challenges with breastfeeding multiples

Each of these situations requires that someone provides a medical assessment and advice beyond what’s normal or typical with breastfeeding, therefore, it goes beyond what a mom can seek help for at a support group.  These private visits can take place in mom’s home, in the IBCLC’s office, at an outpatient clinic, at a medical practitioner’s office, or similar places.  Most of the time these visits have a fee associated and sometimes insurance will pay for these visits.

Where you can find an IBCLC in your area:

• Ask your friends

• Ask your baby’s pediatrician

• Search for a local breastfeeding coalition

• Call the breastfeeding warm line at the hospital or ask your midwife/OBGYN

• Ask your WIC Peer Counselor

• Search for an IBCLC in your area on the ILCA website

• Google “IBCLC” and the name of your town or city

• Ask for a recommendation on Facebook

• Attend a support group led by an IBCLC

Where have you found breastfeeding support in your neighborhood?  

Was it easy to find this support?

When It's Time to Find a New Lactation Consultant

Recently, I have noticed many conversations online where breastfeeding mothers have expressed feelings of despair and frustration that their needs were not met while working with a lactation consultant. In fact, this isn't just happening online, but also in my community as well. 

Last week, my appointment with a new mom started off with her explaining that she was feeling very fragile and insecure, as she had already met with a lactation consultant and it didn't go so well.  When I asked her what happened, she described a lactation consultation that had gone completely wrong.  In a nutshell, the IBCLC told the mom that if she followed her pediatrician's advice (which I actually thought was quite reasonable advice) that she would completely lose her already low milk supply (which was absolutely not the case) and that she should just consider bottle feeding her baby if her nipples hurt that badly.  At the end of the consultation, the mom felt completely defeated and that she was a horrible mom for wanting to follow her pediatrician's advice. 

This story absolutely infuriated me! 

How could this have happened?  How could this wonderful mom, who had been proactive about resolving some minimal breastfeeding challenges, suddenly feel inadequate and ill-equipped to take care of her new baby?  How could this lactation consultant have had such a negative impact on this woman's elf-esteem, especially during such a vulnerable time?

In the midst of all of these negative stories, I felt compelled to write an article listing some situations that indicate it is time to see a new lactation consultant.  I'd like to apologize upfront.  Some may find that the tone of this article is somewhat harsh, but I have to say that I am pretty fired up right now.  I am angry about how breastfeeding mothers are mistreated.

When it is time to find a new lactation consultant? 

The lactation consultant makes you feel like a bad mother

While the purpose for a lactation appointment with me is to improve breastfeeding challenges, my utmost goal is that I help the breastfeeding mom see what she is already doing well and to offer positive emotional support and guidance.  Being a new mother can be incredibly overwhelming and I remember second guessing everything I was doing, as this was completely unfamiliar territory.  No matter what the situation, there is always something that you are doing well and that is what the appointment should build upon.  If you are made to feel like you are doing everything wrong, then it's time to seek the help of a new practitioner. 

The lactation consultant doesn't provide you with  reasonable rationale for her recommendations

You are allowed to question any advice given to you by any practitioner... that is your right as a parent.  If something doesn't seem correct, ask the LC for her rationale.  If she can't provide you with a reason for her suggestions, or she seems upset or bothered that you would question her recommendations, the it's time to find a new LC.

The lactation consultant seems more concerned that you breastfeed than meeting your individual needs

Yes, breastfeeding can be great!  Yes, breastmilk is far superior to formula!  Yes, you clearly want breastfeeding to 'work'.... why else would you have called an LC for help in the first place???  Yet, while breastfeeding is optimal for your health and your baby's health, the first questions that an LC should ask is, "What do you want to work on today and what are your breastfeeding goals?"  The consultation should be all about YOU and YOUR needs, not what the LC thinks is most important.

You don't feel like there is a positive connection between the two of you

When you work with a lactation consultant, you should feel like this person truly cares about you and your child. Your needs and your baby's needs should come first.  Our mission is to help you meet those needs in the simplest way possible.  Sometimes the path to meet your goals is not easy...sometimes it is downright complicated (think twins with tongue-ties!),  but you should feel like the lactation consultant cares about you and your baby, both physically and emotionally.  She should support your wishes and help you to meet your goal.  And if your goal changes, she should stand behind you for those as well.

You just want a second opinion

Think about it, if you were dealing with a medical issue and you didn't totally like the doctor's recommendation, wouldn't you seek a second opinion?  When our son was having behavioral and developmental challenges, we not only spoke with our pediatrician, but also an osteopath, a chiropractor, and a nutritionist.  It was the osteopath that finally figured out that my son had a gluten intolerance, not a developmental delay, and we were so thankful that we had an opportunity to seek out additional opinions.  There have been times when I have recommended my clients to seek a second opinion from a physician, chiropractor, and even another local lactation consultant, if I felt that it would help her baby.  There's no shame is saying that you would like a second opinion.

As with all things related to breastfeeding and parenting, you should always feel supported, not judged, by your health care providers.  Breastfeeding CAN be wonderful and relaxing and joyous and fulfilling, especially if you surround yourself with supportive, caring, and nurturing family, friends, and practitioners!   There are many qualified International Board Certified Lactation Consultants (IBCLCs), around the world, who would love to provide you with the type of support you desire.  You deserve to be with the one who's the best fit for you!

*** As a side note, these scenarios could also indicate a reason to find ANY new health practitioner, as they are relatable to many different professions as well.