Finding a Lactation Consultant or breastfeeding-support person may
seem like a daunting task but it is well worth the effort. First, a few things
to know:
La Leche League is an international group of women who give mother-to-mother peer
support. They are a wonderful resource for support and information and run
support groups in cities all around the world. https://www.lalecheleague.org/
La Leche League Canada
Mother to mother information and support by phone & email
Community Groups for pregnant and nursing mothers.
Website information and publications for families and health
professionals.
www.LLLC.ca
Find Local Groups: www.groups.LLLC.ca
Breastfeeding Referral Service 1-800-665-4324.
Office E-mail: Cette adresse e-mail est protégée contre les robots spammeurs. Vous devez activer le JavaScript pour la visualiser.
Tel: 613-774-4900 Fax: 613-774-2798
Lactation Consultants are International Board Certified Lactation
Consultants this means they are registered Lactation Consultants, IBCLC, RLC
who are required to keep current with breastfeeding information and must
recertify every five years. We provide hands-on clinical support and are
trained to work with all breastfeeding-related problems. In order to certify we
must have many thousands of hours of practical hands-on training and must have
completed many education credits to write the international exam in the first
place.
To find a Lactation Consultant, contact www.ilca.org for a worldwide
search or IBLCE https://www.iblce.org/international%20registry.htm or your local
Lactation Consultant association: or, in Canada, the Canadian Lactation
Consultants Association is also a good resource: https://www.clca-accl.ca/. In
the USA, https://www.uslcaonline.org
Breastfeeding Clinics may be found in many hospitals. Most clinics are
staffed by IBCLCs, though not always. See Resources list (link to Resources
under Breastfeeding Help)
Of course, getting the best start is the way to go, and having as few
interventions during labour and delivery will help a mother to get that best
start. Having a Midwife and/or Doula as support during labour is usually a good
assurance that the labour will go as naturally as possible.
Midwives: though experts in pregnancy and labour support, they are also trained
to counsel mothers in getting a good breastfeeding start.
In Ontario: Association of Ontario midwives: www.aom.on.ca (“find a
midwife” function).
In Canada: Canadian Association of Midwives: www.canadianmidwives.org
Doulas may also be trained in breastfeeding support. A Doula is a
labour-support person. Doulas may be found through DONA at https://www.dona.org
or through CAPPA at https://www.cappa.net or in Canada:
https://www.cappacanada.ca .
HOW TO CHOOSE A GOOD and HELPFUL BREASTFEEDING-SUPPORT PERSON
• When you
seek help from a Lactation Consultant (LC), you should not feel that she is
mainly trying to rent or sell you some product. The Lactation Consultant is
there to help you with your breastfeeding problem, and very often help does not
require any products. Even if you do need to rent a pump, for example, you
should not feel that the lactation consultant is focussing on sales or rentals.
Certainly, if she does sell you a pump or product, this sale time should not be
included in her hourly fee.
• No matter
what your problem, a good LC should not be telling you that you cannot
breastfeed. We hear of some Lactation Consultants and doctors telling mothers
they cannot breastfeed. Do not believe them. If you have nipples you can
breastfeed. Women are often told they must stop or interrupt breastfeeding due
to illness or a medication they are taking or a test they must undergo--this is
only very rarely true. See handouts You Should Continue Breastfeeding 1 and 2.
• No LC or
breastfeeding-support person should ever bring formula with her to your home.
LCs are not allowed to distribute formula samples or recommend a formula by
name. Ask her ahead of time if she intends to bring some formula samples with
her. This may be an indication of her true support for breastfeeding.
• Nipple
shields and bottles are being used much too often to try to fix breastfeeding
problems, even though they can, very occasionally, be useful. Nipple shields
should never be used for the baby who refuses to latch on before the mother's
milk 'comes in' on day three or four (or sometimes later). Once the milk 'comes
in', many babies will latch on easily without a nipple shield. There are
usually better ways of supplementing or feeding babies than using a bottle. Be
sceptical if you LC is quick to use a nipple shield. Patience, perseverance,
and good technique are almost always good enough to get any baby latched. See
handout When Baby Refuses To Latch On.
• REMEMBER to
Get the best Start: Try to ensure and aim for the most natural labour possible.
A good Midwife or Doula may be an invaluable way to achieve that goal.
BE WARY IF:
You are told to feed x number of minutes per side
• Babies can
feed well being on the breast short periods of time, and can feed poorly being
on the breast all day
• Timing is
meaningless and tells us nothing about what the baby is actually getting and
whether or not it is enough
You are told to feed x number of times per day
• A baby who
feeds well 6 times a day is better off than a baby who feeds poorly 12 times a
day
• There are no
studies to support the claim that a baby must feed 8-12 x/24 hour period. None
whatsoever.
You are told to wake the baby every x number of hours
• A baby who
feeds well will wake up when he's ready; if a baby feeds so poorly that he
won't wake up on his own, there is no point in waking him up so he feeds poorly
more times a day; the point is to get the baby feeding well.
Your breastfeeding-support person weighs the baby before and after
each feeding
• What does
this tell us? Even if the scales could be relied on as always accurate—so
what? A 15 gm gain, for example, may mean baby consumed 15 mls of
breastmilk—but what kind of breastmilk? 10 am breastmilk? 3pm breastmilk?
Tuesday’s breastmilk? The beginning of the feeding breastmilk? The end? What?
Ensure baby is actually drinking instead of just sucking, and follow our
Protocol to Increase Intake of Breastmilk. Watch the video clips. That’s how
you will know baby has had enough.
• Test weighs
have been known to show many false negatives. See Handout Is my Baby Getting
Enough?
Your breastfeeding-support person tells you that sore nipples are
normal and you need to endure it, or that your nipples need to “toughen” up or
that your skin is overly sensitive, or, if you are a red-head, that you are
supposed to have overly-sensitive nipples
1.
A good latch prevents and fixes sore nipples
2.
Pain that endures for many weeks may mean there is something else
going on—please see a Lactation Consultant to get this checked out
3.
Nipple shields are not usually an appropriate remedy for sore nipples
4.
Skin colour is irrelevant
Your breastfeeding support person asks you to finger feed after you
breastfeed your baby
• If a baby
needs supplementation then that baby should be supplemented at the breast as
long as the baby is latching. Finger feeding is not an appropriate method of
feeding a latching baby. See Handout Finger and Cup Feeding
How Much Should An IBCLC Charge For A Home Visit?
There really is no set rate for IBCLCs and the fees for home visits
range dramatically. In Toronto, there are some support people doing home visits
for $35/hr and some going as high as $180/hr. Please do not let price fool
you—the most expensive IBCLC is not necessarily the best. Do a little
home work and research and ask her over the phone about some of the points
listed above. An average rate is probably around $100/150 for a visit lasting
around 2 hours. This may seem excessive but it is not—keep in mind that a
good IBCLC will save you money in the long run by keeping you and baby
breastfeeding and off expensive formula.
All of our information sheets may be copied and
distributed without further permission
on the condition that it is not used in ANY context
that violates the
WHO International Code on the Marketing of
Breastmilk Substitutes (1981)
and subsequent World
Health Assembly resolutions.