Finding A Breastfeeding Support Person
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
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
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
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.
Find Local Groups: www.groups.LLLC.ca
Breastfeeding Referral Service 1-800-665-4324.
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 http://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:
http://www.clca-accl.ca/. In the USA, http://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)
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
http://www.dona.org or through CAPPA at http://www.cappa.net or in
Canada: http://www.cappacanada.ca .
HOW TO CHOOSE A GOOD and HELPFUL BREASTFEEDING-SUPPORT PERSON
BE WARY IF:
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.
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
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
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 at www.drjacknewman.com. 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
A good latch prevents and fixes sore nipples
Pain that endures for many weeks may mean there is something
else going on—please see a Lactation Consultant to get this checked out
Nipple shields are not usually an appropriate remedy for sore nipples
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
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
Questions? First look at the website nbci.ca or drjacknewman.com. If the information you need is not there, go to Contact Us and give us the information listed there in your email. Information is also available in Dr. Jack Newman’s Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA); and/or our DVD, Dr. Jack Newman’s Visual Guide to Breastfeeding (available in French or with subtitles in Spanish, Portuguese and Italian); and/or The Latch Book and Other Keys to Breastfeeding Success; and/or L-eat Latch and Transfer Tool; and/or the GamePlan for Protecting and Supporting Breastfeeding in the First 24 Hours of Life and Beyond.
To make an appointment online with our clinic please visit www.nbci.ca. If you do not have easy access to email or internet, you may phone (416) 498-0002.