Lactation Professionals: The People Who Can Help Make Your Breastfeeding Goals Happen
Words: Anthonia Akitunde
Visuals: Shelby Eaton Media
Working with lactation professionals can help breastfeeding women sidestep pain and frustration, according to this expert.
Breastfeeding. The name itself reflects its expected ease. You use your breast to feed your child and that’s it, right? Not so, as any woman who has had difficulty with breastfeeding will tell you.
“We've made breastfeeding this thing that as long as you watch a YouTube video or read a book, you're going to have success. But that is not the case,” says Seattle-based lactation educator counselor and doula Anjelica Malone. “Breastfeeding is deeply intimate and personal, and it requires one-on-one support and help.”
The mom of two daughters—both of whom she breastfed—has become an advocate for that type of one-on-one support through her work as a lactation educator counselor. Anjelica recommends working with lactation professionals—someone who can help coach you through this new and at times difficult and emotional process.
“We realize to be successful in business, it's good to have a mentor or a business coach,” she says. “But in breastfeeding, we have nothing like that! We need a woman to feel like she has someone she can call with professional breastfeeding knowledge that's invested in her and her baby and her family.”
How do you find that person? Anjelica gives insight on what lactation professionals can do for you and your family.
Do you have other breastfeeding and pumping questions for Anjelica? You can ask her during her Facebook Live takeover on Thursday, August 31 at 6:30 p.m. EST (3:30 p.m. PST)
The premise of your book is about building a community to help support your breastfeeding journey. Can you talk about that more?
We need to first let women know breastfeeding is not supposed to be done on your own. You should not be the only one with all the knowledge. You should not be the only one who knows how often the baby should be fed. You should not be the only one who knows all the benefits of breastfeeding... We can't do it that way. That puts all the pressure on the woman, and if anything goes wrong, it looks like it's all her fault.
Within your tribe, it should be obviously yourself, a lactation professional, your partner or a good girlfriend, or whoever it is that's going to be in your corner after you give birth. Whether it be your mother, your sister, your college girlfriend, your workout partner, your yoga teacher... You're gonna have somebody there who's probably wanting to help you out.
Then I would also advise that you get somebody from work. Once you've got through all the hurdles of the first few weeks of breastfeeding and you return to work, you're going to need someone at work who [says], "Hey, I'll cover you girl while you're out pumping.”
Read more about how to advocate for pumping at work.
How should women go about finding lactation professionals for their breastfeeding tribe?
When you're in your pregnancy early on, if you know you want to breastfeed, go ahead and reach out to a lactation professional. Ask your OB, ask your midwife, "Do you know of any lactation professionals?" This could be a lactation consultant, a lactation educator, a lactation counselor, a peer lactation professional—all of those people have actual breastfeeding training so they have experience beyond their own anecdotal experience with breastfeeding. They can help most women to breastfeed.
A lactation consultant—an IBCLC [International Board Certified Lactation Consultant]—has advanced training to help mothers with medical conditions, babies who may have cleft palates, if a mother is struggling with some kind of medication she's taking... But that is not the majority of women. The majority of women struggle with getting to latch right, being in pain, deciding how they're going to incorporate breastfeeding in their life, especially if they travel, they work, they're entrepreneurs, that sort of thing.
When you find one of those lactation professionals, they need to be someone that you can call up on the phone. They need to be someone that you can text, that you can say "Hey, I'm struggling right now. I want to do this, but next week I need to travel away, I have no idea how to prepare" or "Hey, I'm crying and breaking down."
...Breastfeeding is not supposed to be done on your own.
[You need someone] your partner can call and say "We're home, day two, she's struggling, she can't get the baby to latch, the baby's screaming."
You need to have someone to call who can say, "I'm going to come and actually see you." Even saying to your partner, "From now on, whenever she goes to nurse, this is your role."
That is one of the main things missing from most women's breastfeeding experience—they have never sat one-on-one with a lactation professional. They've gone to a class with four, five other couples in a hospital; they've gone to a group meeting, a La Leche League meeting or something like that.
But one-on-one with someone who's there to ask them "Hey, what is your history? Have you experienced sexual trauma? Are you on medication? Are you being treated for something right now? How does your partner feel about breastfeeding? Is this something that's going to drive a wedge between the two of you guys? Did you have a previous child and you breastfed but it went horribly the whole time?" Those are all very needed. You need someone who asks you those questions and is willing to help you come up with a plan based on those answers.
What questions should you ask a potential lactation professional before you decide on working with them?
If you know that you're going to be nursing multiples or you happen to deliver your child prematurely or you have really chronic medical conditions that require you to take lots of medications, you want to hire a lactation consultant or you want to go to the local hospital where you'll be delivering and meet with a lactation consultant.
Sometimes lactation consultants do not do lactation support as their full-time job. What you want to do is find out the number of that person or the number of that lactation room in the hospital and give them a call. If you're doing it throughout your pregnancy, you have plenty of time to prepare. You can call over and over again, and say "Hey, when will you be in the office? When can we meet?" And then you can have a conversation about your situation.
First you want to know what kind of training do they have [and] do they actually have training. Doulas are amazing, but typically doulas have training that may not always be as advanced [with breastfeeding training]. I always recommend women have a doula because they're going to be there immediately after birth and be able to help them. But finding someone who has been to an actual lactation, breastfeeding training [is important].
Make sure that whoever you talk to is someone who is able to meet the needs that you have. If you're a single mom and you're going to be doing a lot of stuff on your own, you want to make sure she's really going to be able to provide you that assistance. She's going to be your main one you'll ask questions to, and she needs to be able to give you really good advice for your situation.
The other thing is to make sure you get along, that you vibe. Many moms want to meet the pediatrician's recommendation, which is six months of exclusive breastfeeding. Six months you're going to be spending dialoguing with this woman, texting her, calling her... You want to make sure guys get along!
If you don't feel comfortable with your lactation professional, you're going to either stop breastfeeding or you're going to begin to look all over the internet for information. You're going to find all this stuff, and you're not going to know what is actually the truth. So make sure whoever you hire, you get along with and that they're willing to help you in the way you need help.
You mentioned training. Are there any keywords moms planning on breastfeeding should look out for?
There's IBCLC, which is International Board Certified [Lactation Consultant]. They've taken an exam and all of that. Then there are certified—they have training and they've received a certificate from whatever the organization may be. There's UC San Diego, there's ICEA—those are some pretty prominent people within the birth and breastfeeding world.
You really want to make sure that when you begin to ask questions, they can provide you with real answers. If you feel like they're kind of fudging it, or they [say] "Oh, you don't need to worry about that," that's probably not someone you want to work with. You want to make sure [to work with] someone who eases your concerns, is able to give you lots of information, [and] can refer you to research.
Make sure that whoever you talk to is someone who is able to meet the needs that you have.
And in all honesty, with women in the Black community, it would be good if you can find somebody who looks like you who has experience working with other women like you. I've had people say to me, "I did not feel comfortable showing my breasts to this white woman."
It's something that happens, and you may not think it's that big of a deal, but when you actually get into that really vulnerable situation right after birth, you are thinking of that. And if this woman looks like she's never seen a brown woman's boobs before, you're going to feel a little bit weird about having to ask those questions. If she doesn't seem comfortable around your partner, if—I'm just going to be really honest—if you feel like she has never been in the home of a Black couple before, and she's just here gawking and she doesn't feel comfortable, that's not the one for you. [Laughter]
That need for cultural competency for every aspect of your life is so real! So what happens when you meet with your lactation consultant? What can you expect of that relationship and meetings?
You definitely want to have a prenatal meeting. I cannot stress this enough: prenatal meetings, prenatal meetings, prenatal meetings.
If you meet a lactation professional who doesn't think you need to meet prenatally—that's the wrong one. There's a lot that needs to be dialogued: history with breastfeeding, sexual trauma history, medical condition, all of that. The good lactation professionals that I've met [say], “I wish I could meet with these moms before they give birth.” So if you meet with someone who [says], "I don't do prenatal meetings," bounce.
Have a prenatal meeting to really get to the root of issues that you're facing, and issues that may affect your breastfeeding experience. Then, postpartum, you want to see that person as soon as possible.
If you're having a hospital birth, you may be able to see someone in the hospital, which is great. But they're going to come in for literally 20 minutes max and they're going to maybe come and see you one other time. You're going to be needing to feed your baby eight to 12 times a day, starting day one. So if she only comes to see you one time each day, there are seven to 11 other feedings that you're doing all by yourself. Day two is where the cracks, the bleeding nipples all come in. And that's when pediatricians begin to wonder is the baby actually getting milk, and the nurses are going to begin to ask "How many pees? How many poops?"
If you've only seen that person one time day one, day two? You're already going to be off to a really rough start. You're already begin to be forced formula. And I will tell you, as a woman of color, if you seem like you do not know what you're doing, they will pounce on that. They will begin to say, "You know what? I think you should just use formula."
So having someone to see you day one, day two is very important. If you don't have a lactation professional who can come day one [or] day two, then you need to make sure that [you’re calling the] number for the lactation professional that you already got prenatally: "Hey, I'm here. I know you did rounds this morning and you came and saw me, but I would like to see you again."
Everyone needs to know [that] this woman wants to breastfeed. Your partner needs to know, your sister needs to know, everyone who's coming to visit. And everyone needs to be hounding them: "Hey, has someone come to see her again? Has someone came to check the latch of the baby? Has someone come to evaluate to see if the baby is transferring milk?" There are ways to watch the baby's mouth as their feeding to see if they're actually transferring milk!
Most nurses do not have that training, so nurses do not get actual breastfeeding training in nursing school and neither do physicians. So you need someone to actually watch the feedings. They're not just coming to grab your breasts, grab the baby's head and make sure they're coming together. There needs to be someone there actually evaluating how the feeding [is] going, how you're feeling, all of that.
Make sure you have someone to see day one and day two as much as you can. If you've hired someone privately, go ahead and have them come, don't even worry about the lactation person at the hospital.
If you have a hospital birth, you're probably going to get home day 3, if you have a C-section, you're probably going to be in the hospital a little bit longer. [But] once you get home, there should be someone there. Because that's about the time when your mature milk starts to come in.