Most women in the US do not breastfeed as long as they intend to. Many feel a sense of failure when this occurres. However, these feelings of sadness and anger, are being misplaced onto oneself when they should be fully on our medical system.
Mothers are not failing. Our medical system is failing mothers.
How do we expect moms to successfully breastfeed when many of our doctors, including OBGYNs, Pediatricians, and Family Medicine physicians are not required to take anything more than the minimum education on breastfeeding (usually 1-3 hours course)?
The breast is a very complicated organ, yet in medical school it is mostly discussed in terms of cancer, not it’s intended biological function. How does that make any sense? There is an important body organ that feeds our young and yet doctors that work closely with breastfeeding dyads, don’t need to know anything about it. Formula companies step in daily bringing doctors food and teaching them all about infant feeding.
Breastfeeding often does not go as expected.
Why does a doctor need to know about breastfeeding when there are lactation consultants?
Physicians need to know the normal function of the breast, so they are able to know when to properly refer to a specialist. I hear way too often that when breastfeeding isn’t going well, many pediatricians are not referring to a lactation consultant, instead they advise women to use formula.
What is an IBCLC?
Board Certified Lactation Consultants (IBCLCs) are the experts in breastfeeding. However, most parents don’t know that there are many different “pathways” to becoming and IBCLC and there is no “standard” lactation education. Therefore, some IBCLCs have excellent training and some lack skills and proper education. The minimum training that is needed to take the IBCLC exam is usually not enough to really be of help to parents.
For many, becoming an IBCLC can be challenging from a logistics standpoint. You are required to find a mentor and until very recently, learn from them in person for free, or for a nominal fee, but never paid. This puts the credential out of reach for many interested in becoming board certified lactation consultants, especially to people of color that might not have anyone in their area by which to be mentored or people that may not afford to work for free. As a result, access to an IBCLC becomes very difficult for those that need it most.
IBCLC with oral motor education assessing an infant’s suck.
Barriers that some parents might face when hiring an IBCLC
Difficulty accessing bilingual professionals: In my state of Colorado Latinos make up more than 20% of the state, however, there is only one IBCLC that speaks Spanish. Therefore, these moms are not getting the same level of care as their English-speaking counterparts.
High out-of-pocket costs: Another barrier is that a lactation visit also usually costs between $150-$200 and most often, it doesn’t just take one visit. This financial aspect can mean the end of breastfeeding for many families.
Contradicting points-of-view: In some occasions, IBCLCs find themselves defending they’re practices when doctors go against their professional recommendation. An IBCLC will give one piece of advice, but when the parent tells their doctor that advice, the doctor contradicts it. Therefore, many parents are left not knowing what to do at all.
Lack of evidence-based information: More formal research is needed regarding breastfeeding and all of its benefits. As of now, a lot of information found is based on “experience” vs “evidence”.
With all of these challenges, it is no wonder many mothers do not breastfeed as long as they would like. Until these barriers are diminished, women need to use their sadness and anger felt and direct it where it belongs: on our health care system that at times fails to care of our most precious commodity; mothers and babies.
Moms do not fail to breastfeed, but many of them are failed every single day.
Have you ever hired an IBCLC? What has been your experience working with physicians and specialists regarding breastfeeding?
I have two kiddos that I breastfed, but not without struggles. I understand what it feels like when you thought it would be easy and it’s not. The lack of help that I received from healthcare professionals during this time is what drives my passion for helping others. I also believe that the addition of and eventual transition to solid foods is an important and often taken granted part of long-term health.
