A Better Approach for the Professional Lactation Consultant

By, Erin Wells, BA, IBCLC, RLC (Owner of Lily Lactation)

As a Lactation Consultant, I have the opportunity to work with many pregnant women and new parents. I have noticed that we, the Lactation Community, are often viewed as extremists who use shame, force, and intellectualism to bully families into breastfeeding their babies’. This is troubling for such an important profession as ours. Have we lost our focus as we promote breastfeeding and, if so, how do we get back?

With a quick internet search using some of the derogatory names, “lactivists” and “lacto-nazis,” I found two stories written by two very different moms both making the same point about their experiences with their lactation consultant. The first was a new mom who thought she had been doing a great job with breastfeeding her newborn and the second was a breast cancer survivor who had a double mastectomy. Blogger Michelle Golberg, a new mom, from slate.com writes, “One of the worst moments of my first year with my first child was a visit from a well-regarded lactation consultant. Until she showed up, I’d been thinking that the whole having-a-newborn thing wasn’t quite as bad as I’d feared. Afterward, I was ashamed, overwhelmed, and unsure I could handle parenthood.” In Goldberg’s blog she explains how the lactation consultant told her that her son’s sucking skills and her milk production were inadequate and that she needed to pump 20 minutes between each feed. She states that because she was vulnerable she obeyed and was left feeling ashamed and overwhelmed. Emily Wax-Thibodeaux, breast cancer survivor, writes in the Chicago Tribune, “As the two of them cuddled afterward, I was in a mood that I can describe only as postpartum elation. That is, until those I jokingly call the ‘breast-feeding Nazis’ came marching in to my room. ’You really should breast-feed,’ the hospital's lactation consultants, aka ‘lactivists’ said. ‘I can't. I had breast cancer,’ I said.”  Further in Wax-Thibodeaux’s article she says that even with being told she didn’t have breasts the lactation consultant still encouraged her to breastfeed stating, “Let’s hope you get some milk.” A patronizing approach, shaming and guilt tripping moms to breastfeed and even sometimes forcing breastfeeding upon an unwilling recipient should never be a part of our support.

© Lucidwaters | Dreamstime.com - Mother Breastfeeding Her Newborn Photo

The Lactation Community should be empowering families to make a well-educated decision about how they will feed their babies. Liz Brooks, a lawyer and IBCLC states on her website lizbrooksibclc.com, “IBCLCs have the essential credential for lactation support! They empower mothers and save babies’ lives.” We encourage breastfeeding but shaming and guilt tripping will only repulse families from breastfeeding      

Additionally, “The Surgeon General’s Call to Action to Support Breastfeeding” should be taken seriously for all Lactation Professionals since it is a “Call to Action to Support Breastfeeding” not to force breastfeeding. The document states, “Women who choose to breastfeed face numerous barriers. Only through the support of family members, communities, clinicians, health care systems, and employers will we be able to make breastfeeding become the easy choice, the default choice.”  Every parent gets to choose how they will feed their baby. We should never force any parent to breastfeed.

How do we support those who choose not to breastfeed? In the Ten Steps to Successful Breastfeeding  FAQs, the question is posed:

“Q. If a mother states her preference to formula-feed her infant, how should the hospital respond?

A. Counseling the infant feeding decision should be both patient-centered and family-centered. If a mother chooses not to breastfeed, we would expect the hospital to explore the mother’s concerns about breastfeeding and offer ways to address them. However, if after being informed of the negative consequences the mother still chooses to formula-feed her infant, a level of respect must be maintained regarding her choice. Once she has given birth, she should be taught how to safely prepare formula, provided the best formula options for her infant and shown how to properly feed her infant. Remember, mom’s often make last minute decisions to breastfeed. Hospital processes should be flexible to allow the mother this option.”

The number one principle for the IBCLC in the IBLCE Code of Professional Conduct Principles is to, “provide services that protect, promote, and support breastfeeding”. Shaming, forcing, and guilt-tripping families to breastfeed is unacceptable as a Lactation Consultant. We are to be professional in our support. Let’s make this time in a family’s life a happy time, full of good memories and nonjudgmental support empowering their decisions.

References:

Goldberg, Michelle. Breast-Feeding Extremists Are Even Worse Than You Thought

Courtney Jung’s Lactivism shows just how dangerous their cause can be. slate.com. Dec. 4, 2015 11:07AM

Wax-Thibodeaux, Emily. “Why I Don’t Breastfeed, If You Must Know.” Chicago Tribune. chicagotribune.com. April 8, 2016

Office of the Surgeon General (US); Centers for Disease Control and Prevention (US); Office on Women’s Health (US). The Surgeon General’s Call to Action to Support Breastfeeding. ncbinlmnih.gov. Rockville (MD): Office of the Surgeon General (US); 2011.

Ten Steps to Successful Breastfeeding Q&A. 2012 Baby-Friendly USA, Inc. UNICEF. World Health Organization. babyfriendlyusa.org. 1989

IBLCE. Code of Professional Conduct for IBCLCs. iblce.org. November 1, 2011 updated September 2015.