Breastfeeding does not always go as we had planned. When we were pregnant we envisioned a baby cooing at us and latching on without effort while we blissfully relaxed and enjoyed our new little one. The reality for some moms is a crying baby who simply cannot be consoled and who will not take the breast, despite every effort.
Perhaps it’s 3am and you are having difficulties getting your baby to stay latched to your breast and nurse well. Or maybe you thought everything was going great until you had a visit with a public health nurse. You were told that your baby is not gaining enough and that you need to supplement and you feel completely deflated.
You or your husband may do a quick search online to figure out how to get help with breastfeeding as soon as possible. A whole bunch of local websites come up, but you see each person has various letters behind their names such as IBCLC, CLC, CBE, CBS, CLE, CBC, LLLL and you have no idea what any of that means. It is overwhelming enough to be trying to feed and care for your new baby and now you must do research to navigate which person you want assisting you. Who is qualified to do this, and do they know enough to assist with the intense struggles you and your baby are currently facing?
Here is a Who’s Who of the Lactation World that can help you figure out which person you would like to assist you in getting that precious baby to breastfeed well at last.
Professional Breastfeeding Support:
This acronym stands for International Board Certified Lactation Consultant. To be eligible to write the exam, they have had lactation specific higher education and have already spent years helping mothers and babies with breastfeeding. They are certified by IBCLE which is the International Board of Lactation Consultant Examiners. It is through IBCLE that they write a 5-hour exam that is offered twice a year around the world. After 5 years they must either rewrite the exam or submit education hours specific to breastfeeding. This is because they want registered lactation consultants to be very current in the latest information in this rapidly growing field. They need to submit 75 hours of education at the 5-year mark. However, after 10 years of holding this designation, they must rewrite the 5-hour certifying exam.
IBCLCs are healthcare professionals and they can work in private practice, in hospitals or in a clinic. They can educate families and other healthcare professionals with classes and workshops, teaching them about the specifics of breastfeeding. They work with breastfeeding dyads experiencing basic and also more complicated challenges. They are completely qualified to assess Mom and baby for any issues that are beyond the normal course of breastfeeding and can give advice on how to proceed when they face such challenges. They can refer to other clinicians (dentists, doctors, etc.) if necessary for further treatment (such as for tongue tie or torticollis).
This is a Registered Lactation Consultant and is another designation for an IBCLC (above). It is trademarked by the IBCLE (International Board of Lactation Consultant Examiners).
Breastfeeding Support by Various Certifying Organizations:
A Certified Breastfeeding Specialist has taken an online course with Lactation Education Resources. There is an option of a 90-hour course (enriched) or a 45-hour course (core) and there is an exam at the end of the course. They have to re-certify after 5 years.
They assist and support families with breastfeeding issues in uncomplicated situations. They refer out to an IBCLC if the breastfeeding situation is more challenging than their scope of practice allows.
A Certified Lactation Counsellor may have taken a course with ALPP (The Academy of Lactation Policy and Practice). The course is 45 hours and they have to pass the exam offered. Their certification must be renewed every 3 years by submitting 18 hours of continuing education.
They may also have taken a course offered by Healthy Children Project Inc, Center for Breastfeeding. It is a five-day course and there is an exam on the final day. There is no recertification process.
A certified lactation counsellor can work with families on basic breastfeeding issues. They would need to refer out to an IBCLC if the issue was beyond their scope of practice.
A Certified Lactation Specialist has taken a course offered by Lactation Education Consultants. It is a 45-hour course and you have to pass the exam at the end of course. The designation is good for 5 years at which point you have to recertify.
This person can counsel and teach breastfeeding mothers on normal breastfeeding issues. They will refer out if the problem is more complicated.
A Certified Lactation Educator is certified through CAPPA which stands for Childbirth and Postpartum Professional Association. They have to take a 20-hour course and pass the exam. Part of their certification is reading the training manual and required books, attending breastfeeding support meetings, shadowing an IBCLC or CLC for 4 hours and reviewing current research. They have to do 15 hours of continuing education every 3 years to maintain certification.
Someone with this designation will assist families with the normal course of breastfeeding. They can assist with basic breastfeeding issues, but they cannot take a medical history, do a clinical assessment of the mother’s breasts or baby’s mouth, prescribe nipple shield, supplemental nursing systems or topical ointments. They will refer out to an IBCLC if the issue is beyond their scope of practice.
This is a Certified Breastfeeding Counsellor which is offered through Childbirth International https://childbirthinternational.com/ They have an online course after which they have to do book reviews, 30 hours of breastfeeding support, an open book exam and some assignments. There is no recertification process or continuing education.
A breastfeeding counsellor would be someone who can assist with basic breastfeeding issues. They will work with families and assist them with their breastfeeding challenges but would have to refer out to an IBCLC if the issue was beyond their scope of practice.
A Certified Breastfeeding Educator has taken an online course with Birth Arts International. They have reading requirements, workbook activities, have to attend local meetings such as La Leche League, do a research paper and shadow an IBCLC. They do not have to recertify or do continuing education.
They will work with families to assist with basic breastfeeding issues. They would need to refer to an IBCLC with a breastfeeding issue that is beyond their scope of practice.
La Leche League Leader is a volunteer who has breastfed a child for at least 9 months and has gone through the accreditation process to become a leader. This is done through La Leche League Canada which is part of La Leche League International. The accreditation process involves required reading, writing about their personal experience, following some written curriculum and supporting the La Leche League philosophies.
A leader offers monthly meetings in the area and phone support. Some leaders will offer home visits, but it isn’t required of them. A leader can assist you with basic breastfeeding information and emotional and practical support. Meetings are designed for mother to mother support where the leader facilitates the discussion and all the mothers attending can offer information and support to each other. A leader can assist a Mom in discerning if her issue requires assistance from someone more. She would have a list of community resources that she can provide so moms know where they can get help in the area.
This is a Breastfeeding Peer Counsellor and is offered under WIC (Women, Infants and Children), a federal assistance program in the United States that supports low-income families. They attend a training class, observe other peer counsellors and read assigned books. This is not available in Canada.
A BFPC will work with mothers providing basic breastfeeding information and support. They will counsel by phone, at the WIC clinic, home visits or hospital visits. They will refer mothers elsewhere as needed, according to their protocols.
Terms such as LE (Lactation Educator) or LC (Lactation Counsellor or Lactation Consultant) may be used by someone who has done some training but not completed it to become certified. Or someone may simply use those designations with no formal training (perhaps just doing their own reading, attending a workshop or their own experience) as they are not trademarked.
You can see there are many options out there. The breastfeeding world has truly expanded in recent years as more and more Moms want to breastfeed. Hopefully that helps you understand the complicated labyrinth of the levels of lactation support.