Six Things IBCLCs Wish All Doulas Knew About Lactation Support

1. Your presence in the early hours and days postpartum places you in a key position to support nursing.

By learning all you can about lactation and infant feeding, you can help parents and babies get off to a good start.

“Doulas should understand they can help clients reach their breastfeeding goals by ensuring babies feed 10 to 12 times every 24 hours, avoiding supplements (unless medically necessary), and keeping baby close to avoid missing feeding cues,” says Christy Jo Hendricks, IBCLC, CLE, CCCE, Doula.

Jodi Utter, CLD, CPD, CBE, LE, NCS adds “I’m often the first person to recognize breastfeeding concerns. I can assist with education and support of proper positioning and latch, but find many clients require an evaluation with an IBCLC. I never hesitate to refer for additional evaluation and guidance to keep the breastfeeding relationship strong.

“One of my favorite things is being present during an IBCLC visit. Not only does the client learn, but I do as well, and I’m able to reinforce what has been advised on an ongoing basis. My relationship with local IBCLC’s has not only benefitted my postpartum clients, it has also helped me recognize problems and refer much more quickly.”

2. Knowing when to refer to an IBCLC is key, and time is of the essence.

By having IBCLCs you work with and trust, you can quickly connect your clients with needed help. Nipple or breast pain, concerns about infant weight loss or slow weight gain, issues with milk production, parents supplementing when they don’t want to be, and plugged ducts are all urgent concerns that warrant a fast referral.

Laurel Wilson, IBCLC says, “Doulas should be well versed on the impacts birth has on early breast/chestfeeding, as well as long-term potential impact. Many things during labor and birth can really change how parent and baby are able to respond to one another, on an emotional and hormonal level, as well as a physical response. Everything from the position of the baby in utero (think breech position, shoulder dystocia, bruising of the baby’s head), to stimulation of the baby at birth (bright lights, separation, painful procedures, rushing first feeding), to the medications and type of delivery (epidural, narcotics, cesarean birth). These situations can have a complex impact on the breast/chestfeeding couplet. Lactation and breast/chestfeeding can be a multi-year event so it is critical for doulas to think about how their support can influence lactation and the long-term health of the baby.”

3. Providing un-biased support is key.

“I wish I all doulas knew you can’t want it more than the client does–or it comes across as judgment, even with the most well-meaning approach,” Kimberly Bepler, IBCLC, CPD, CLE, CNPE advises.

“Doulas should learn the many benefits of breastfeeding to both the parent and the baby, so they understand why so many of their clients are passionate about this feeding decision,” Christy Jo Hendricks adds.

4. Stay in your scope and be clear with clients about your limitations.

Parents are often confused by the variety of lactation related certifications; help them know what you can and cannot do.

“Recognize when something is outside of a doula’s scope and refer early. It can complicate a situation if a referral is made too late,” says Christy Jo Hendricks.

Jodi Utter adds, “I believe there’s a high level of trust between postpartum doulas and IBCLC’s. As a doula, I trust the IBCLC knows I ‘ve done everything within my scope to help, no matter what is being presented. I am grateful to have a network of IBCLC’s who offer the professional, compassionate care my postpartum clients need.”

5. Just as you don’t undermine your clients’ confidence in their doctor or midwife, please support their IBCLC.

If your clients have lactation questions, encourage them to dialogue with their IBCLC. Parents can get frustrated by conflicting lactation advice.

Kimberly Bepler explains, “Even though doulas might have experience or opinions about how breastfeeding should go with their client, the lactation consultant creates the plan and the doulas put feet to it. However, doulas can provide valuable insight into the mother and baby dynamic that might help the IBCLC customize a plan.”

6. Doulas benefit when they collaborate with IBCLCs.

Aleca Murphy, certified newborn care specialist and certified postpartum doula, shares, “I think the relationship of working with an IBCLC as a postpartum doula helped build my confidence around chestfeeding and kept me informed of up-to-date feeding practices. So much had changed since my postpartum training. Having a personal relationship with an IBCLC gave me a place to ask questions where I didn’t feel judged.”

“One of the best ways I’ve been able to grow my business and offer great lactation care for my clients is by teaming up with a local IBCLC I can reach out to for immediate help with clients,” says Katie Nyberg, CLD, CPD, CLE, CNPE. “Finding a great IBCLC means you can confidently refer your clients to great care, which is also a reflection on your professionalism!”

About the Author

Julie Brill, IBCLC, CCCE, CLD is a lactation consultant in private practice, working virtually with families all over the U.S. and beyond. For the last twenty years, Julie has trained childbirth educators and doulas for CAPPA. She teaches doulas and educators a virtual, three-hour workshop to help perinatal professionals stay current on the ever-changing world of lactation, with the goal of having all professionals that new families work with provide consistent feeding advice. Julie is the author of Round the Circle: Doulas Share their Experiences and the mother of two adult daughters.

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