Tag Archives | lactation

Applications Being Accepted for IBCLC CARE AWARD!

careawardThe International Board of Lactation Consultant Examiners® (IBLCE®) and International Lactation Consultant Association® (ILCA®) are once again proud to announce the IBCLC Care Award is ready to be launched for 2013.

This first Global IBCLC CARE AWARD recognizes Hospitals and Community facilities.

All Hospitals/birthing facilities/birthing services and Community Based facilities who have achieved the specific criteria are eligible to receive the IBCLC Care Award for a 2-year period. The Award is presented to facilities in recognition for staffing professionals who hold the prestigious International Board Certified Lactation Consultant® certification (IBCLC®), for those who continue to provide a lactation program, or activities that protect, promote, and support breastfeeding , and those who can demonstrate that they have a commitment to breastfeeding training of medical staff who care for new families.

Be sure to check if you meet the specific criteria for your facility today and apply!

IBCLC Hospital Care applications are OPEN September 27 through to November 29, 2013. IBCLC Community Care applications OPEN February 3 to March 21, 2014.

Learn more about the IBCLC care Award at www.ibclccare.org.

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How Often Does Breastfeeding Just Not Work? (from Dr. Alison Stuebe and the Academy of Breastfeeding Medicine Blog)

Occasionally on Lactation Matters, we find a blog post that is so incredibly important that we want to do everything in our power to make sure all ILCA members can read it.  This is just such a post from Dr. Alison Stuebe. Dr. Stuebe is a maternal-fetal medicine physician, breastfeeding research, and assistant professor of Obstetrics and Gynecology at the University of North Carolina School of Medicine. She is also a member of the board of the Academy of Breastfeeding Medicine. So often, as we study lactation, we talk about the “HOW”…this post asks “WHY”.  Thank you, Dr. Stuebe for allowing us to republish your blog post here on Lactation Matters. It was originally published on the Academy of Breastfeeding Medicine blog.

How Often Does Breastfeeding Just Not Work?

By Dr. Alison Stuebe, MD, MSc

Jessica Isles posted a great question today on my blog, “When Lactation Doesn’t Work:

I was wondering if any comparative studies have been done on the statistics of lactation failure in various cultures both developed and less developed. Please post if you are aware of any – or any statistics on how many women’s milk never comes in (in the US), with a healthy full term new born, in an environment supportive of breastfeeding. We need to help mothers who struggle with this.”

That’s a great question – and a difficult one to answer. Marianne Neifert estimates that “as many as 5% of women may have primary insufficient lactation because of anatomic breast variations or medical illness that make them unable to produce a full milk supply despite heroic efforts.”   [Neifert MR (2001). “Prevention of breastfeeding tragedies.” Pediatr Clin North Am 48(2): 273-97.]

We are working on a research project to try to estimate the proportion of women in the Infant Feeding Practices Survey II who experienced unplanned, undesired weaning due to physiologic problems with breastfeeding. One challenge is what to call this condition. I’ve written a draft of the paper using the term “failed lactation,” but I don’t like it.  I have problems using the word “failed” to describe mothers who have gone to heroic lengths to sustain breastfeeding. We’ve also tossed around “lactation dysfunction” or “unwanted weaning,” but those don’t quite cut it either. I want a phrase that health care providers will take seriously and moms will perceive as a lifeboat in a storm, not as insult added to injury. My personal favorite is “Lactastrophe,” but I suspect that would not make its way into the medical lexicon. What do you think we should call it when lactation doesn’t work?

We’re also finding that it’s quite difficult to tease out the issue of “a supportive environment” vs biological problems with lactation. It’s a bit like trying to tease out how much of the type 2 diabetes epidemic is caused by “biology” vs “the environment.”  Over the past two decades, the proportion of our population that is obese has sky-rocketed, in the setting of decreasing physical activity, ballooning portion sizes, neighborhoods without sidewalks, and worsening economic inequality and job insecurity. Some people who live in this country have developed diabetes, and some have not.  It’s likely that some individuals have a biological predisposition that makes them vulnerable, whereas others do not. Regardless of the precipitating factor, however, these patients need help to control their blood sugars.

Similarly, for lactation, there are some mothers who are blessed with ample milk supplies and with babies who are born with a championship suck-swallow pattern, and they would be likely to breastfeed successfully in just about any environment. And there are other dyads for whom one piece of bad advice or a nasty encounter with a stranger while breastfeeding in public is enough to throw lactation completely off track.  Furthermore, it’s likely that women who have been socialized to mistrust their bodies are more vulnerable to interpreting early feeding challenges as evidence that their bodies can’t sustain breastfeeding– and they are thus more likely to wean and attribute their decision to a physiological problem.

From a health and wellbeing perspective, however, I’m not sure that it matters whether we “count” both “biological” and “perceived” insufficient lactation together. The total burden of this problem is enormous, and mothers are suffering, whether they lack glandular tissue and or they lack self-efficacy and support.  We need mothers for whom lactation doesn’t work to know that they are not alone.  And we need to demand research to develop the tools that will identify the underlying problems and allow us to implement the appropriate treatment.

We also need to step back from assertions that every mother can breastfeed, if she just tries hard enough. As Neifert has written, “The bold claims made about the infallibility of lactation are not cited about any other physiologic processes. A health care professional would never tell a diabetic woman that ‘every pancreas can make insulin’ or insist to a devastated infertility patient that ‘every woman can get pregnant.’ The fact is that lactation, like all physiologic functions, sometimes fails because of various medical causes.”

Lactation is part of normal human physiology, and like all other human physiology, it can fail. It’s time to stop bickering about whether this mom tried as hard as that mom to breastfeed. We have too much work to do.

Please take the opportunity to visit the Academy of Breastfeeding Medicine’s blog and leave your comments.

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Happy Birthday!

When I meet someone for the first time and they ask what my profession is, I usually receive a raised eyebrow when I tell him/her that I am a lactation consultant.  This raised eyebrow is typically followed by either, “What type of consultant?” or “Wow, I could have used you when I had my kids (followed by a 5 minute soliloquy of her breastfeeding challenges),” or “Well, why would someone need a lactation consultant?  Isn’t breastfeeding easy?”  As lactation consultants, we are often working on our own or with other health professionals who don’t truly appreciate all we do for mothers and their families.  We don’t just help mothers breastfeed….we nurture a mother’s self-confidence as she enters the full-time profession of motherhood.

To be a successful lactation consultant does not mean that we make a ton of money (wouldn’t that be nice???)  Instead it means that we provide gentle, emotional (and breastfeeding!) support  to those families who need it the most.  But where do we receive our support?  Sure, we attend professional development seminars and workshops.  We might network with colleagues.  We might volunteer at our local county breastfeeding coalition.  All in all, we could use more support, just like our moms.

In answer to our need for support, we would like to introduce ILCA’s newest support system: Lactation Matters, the official blog of the International Lactation Consultant Association.  In this blog, you will hear from authors about their latest research, in 600 words or less!  You will learn tips from colleagues who are setting up outpatient clinics, non-profit organizations, and private practices.  You will be exposed to international news about breastfeeding from around the world.  All of our articles will be focused on supporting lactation consultants and breastfeeding professionals with pertinent research, tools and tricks of the trade, and global movements in breastfeeding promotion.  It serves as the perfect complement to ILCA’s monthly member newsletter, e-Globe.  Lactation Matters will help us take one more step to meeting ILCA’s vision and mission: Our vision is a worldwide network of lactation professionals. Our mission is to advance the profession of lactation consulting worldwide through leadership, advocacy, professional development, and research.

We look forward to sharing our knowledge and experiences with you.  We hope that it will nurture your education and self-confidence as a health-care professional and lactation consultant.  We also hope it will inspire you to share your knowledge and experiences with us as well!   If you find an article that you feel your colleagues would benefit from, please link to it from your Facebook page or Twitter account and add comments to the bottom of the blog to keep the conversation going.  If you are interested in submitting an article to Lactation Matters, please contact us at lactationmatters@gmail.com.

Robin Kaplan, M.Ed., IBCLC, Lactation Matters Editor, Owner San Diego Breastfeeding Center

Decalie Brown, RN, CM, CFHN, IBCLC, ILCA Director of Marketing

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