Lactation Consultants Affecting Breastfeeding Success

Lactation Consultants

Affecting Breastfeeding Success

"The role of the lactation consultant was developed to provide high-quality, competent, comprehensive consultation in breastfeeding and lactation management"

(International Lactation…, as cited in Thurman & Jackson Allen, 2008, p. 2).

Breast milk serves as the ultimate option for infant nutrition, according to the U.S. Department of Health and Human Services' (DHHS), and the American Academy of Pediatrics (AAP). In the journal publication, "Integrating lactation consultants into primary health care services: Are lactation consultants affecting breastfeeding success?," Sara Elizabeth Thurman, MSN, RN, FNP-BC and Patricia Jackson Allen (2008), MS, RN, PNP, FAAN report that within the next year, the U.S. DHHS Healthy People 2010 initiative aims to confirm that 75% of mothers have initiated breastfeeding immediately postpartum; that 50% of mothers are continue breastfeeding at 6 months postpartum; that 25% of mothers maintain breastfeeding at one year. During this essay, the researcher reviews the article by Thurman and Allen, simultaneously relating personal impressions, opinions and comments relating to the primary question this study addresses: "Are lactation consultants affecting breastfeeding success?."

Study Components

To address this research question in this qualitative case study, Thurman and Allen (2008) evaluated the relevance of a number of articles on the use of IBCLCs in outpatient and primary care settings, accessed from the Cumulative Index to Nursing and Allied Health Literature, the National Library of Medicine Ovid Medline, PsycINFO, and Google Scholar. These researchers then identified and retrieved a total of five studies, published in the English language, that included human participants, to later examine. Key words utilized in the search for literature included words such breastfeeding, lactation consults or consultants, lactation, and social support. The researchers additionally determined the inclusion criteria would include articles with references to IBCLC certification in any manner. The references to IBCLD included "authorship, abstract, methods, or discussion; study cohorts that utilized IBCLCs for a breastfeeding support intervention…. & #8230;[also] limited to include research that studied the use vs. nonuse of IBCLCs in outpatient settings and excluded studies…solely conducted in the hospital environment" (Thurman & Allen, 2008, p. 3). The researchers excluded studies that did not include the IBCLC affiliation from this review. In an effort to maximize the number of articles for review, Thruman and Allen excluded studies with outcome exclusion criteria. The researchers also examined references from research articles (ancestry searching) which met the review criteria for their study.

Breastfeeding Considerations

Breastfeeding provides numerous health benefits for both the mother and the infant, and also to the nation's overall public health. Even though a number of U.S. planning guides and policy statements on breastfeeding confirm that both infant and mother benefit from breastfeeding, breastfeeding rates in the U.S. do not meet breastfeeding goals set by Healthy People 2010. Consequently, Thurman and Allen (2008) assert that "breastfeeding education, promotion, and supportive interventions are crucial in helping mothers in the U.S. increase breastfeeding initiation and duration rates" (p. 7). Some of the reasons a mother may choose not to breastfeed her infant or determines to discontinue breastfeeding earlier than recommended include a variety of personal and societal reasons, which include but may not be limited to the following

Personal Reasons

1. Sore nipples,

2. infant difficulty with latch, and

3. perceptions that they were not producing enough milk to satisfy their infants.

Societal Barriers

1. working outside the home,

2. length of maternity leave, and

3. embarrassment of breastfeeding in public (Thurman & Allen, 2008).

Figure 1 depicts the breastfeeding percentages the U.S. DHHS set for their Healthy People 2010 Goals.

Figure 1: U.S. DHHS Healthy People 2010 Goals (adapted from Thurman & Allen, 2008, p. 1).

As the quote introducing this essay notes, the lactation consultant's role is to "provide high-quality, competent, comprehensive consultation in breastfeeding and lactation management" (International Lactation…, as cited in Thurman & Jackson Allen, 2008, p. 2). In the literature, albeit, the title "lactation consultant," liberally used, does not assure the consultant is a professional. A professional lactation consultant undertakes the primary duty of providing new mothers with high-quality, appropriate, extensive consultations on how to best manage their practice of breastfeeding their baby. Prior to the end of the twentieth century, the U.S. did not have a program to "certify" breastfeeding helpers or consultants.

Now, however, the International Board Certified Lactation Consultant (IBCLC), a recognized credentialing agent in breastfeeding support, assures a specific standard of education, training, and knowledge that non-certified "lactation consultants may not possess (Thurman & Allen, 2008, p. 2). Along with earning educational credits relating to breast feeding, individuals with Certified Lactation Consultant credentials must complete extensive clinical training with breastfeeding mothers and earned a passing grade on the final lactation consultant's exam. Once the individual passes the exam and has been certified, the professional lactation consultant must re-certify every five years. After 10 years, the lactation consultant must re-take the exam for recertification. For mothers to become knowledgeable about what may happen when they start breastfeeding, it is vital that they receive proper informative information regarding breastfeeding. Healthcare providers sometimes fail to provide new mothers with information explaining the benefits of breastfeeding over formula feeding (Thurman & Allen, 2008, p. 1).

Professionals who are knowledgeable about breastfeeding serve as one of the key components in not only encouraging new mothers to breastfeed their babies, but also in educating family members regarding the significance of breastfeeding and the value of supporting the mother to breastfeed her baby. Thurman and Allen note: "Breastfeeding initiation and breastfeeding maintenance benefit from the skills and assistance of a supportive experienced individual" (Ibid.). according to Thurman and Allen, a professional lactation consultant works collaboratively with primary care providers:

to assure appropriate clinical/practical management of breastfeeding and lactation in order to protect, promote, and support breastfeeding. Such practice includes providing education, counseling, and clinical/practical management to allow breastfeeding to be seen as the expected way in which healthy newborns are to be fed as well as to prevent and solve breastfeeding problems. Education efforts extend to the community as well as to breastfeeding families and health care colleagues. (Thurman & Allen, 2008, p. 1)

Conclusion

Thurman and Allen (2008) report that interventions the IBCLC implement include:

1. Educating parents on breastfeeding, along with

2. "hands on" instructions explaining how to breastfeed an infant, and also

3. explaining the use of breast pumps to new mothers. (Thurman & Allen, 2008, p. 8)

At times, IBCLC relates instructions regarding breastfeeding one on one to individuals. Other times, they may share directives and pertinent point over the phone. Thurman and Allen (2008) assert that pediatric and family nurse practitioners and physicians and other individuals who routinely provide prenatal care visits, conduct nursery discharges, as well as conduct well child check-ups to infants and breastfeeding mothers prove to be excellent candidates for IBCLC certification.

For this essay, the researcher interviewed a friend, Lana, who related her personal experience with breastfeeding. "At the age of 25, Lana said, "When I had my first daughter, I decided to breastfeed her. The hospital where I gave birth to my daughter, however, did not have lactation consultants. In fact, no one made a point to talk about the breastfeeding process, even after informing one of the nurses of the problems I was experiences. My problems included my daughter latching but not getting any milk. In addition, I suffered from having sore nipples. Still no one at the hospital offered any help. After two weeks of trying to breastfeed my daughter, I gave up." Lana said that if she had to do it over again, she would have insisted on help.

According to Thurman and Allen (2008), as the IBCLC profession continues to grow, the evidence-based need for IBCLCs will likely also increase in primary care. Along with this growth, if primary care providers collaborate with IBCLCs to provide breastfeeding management and support to parenting families to promote best practice protocols for infant nutrition and family health, the researcher contends, the mother and baby will not only benefit health wise, they will benefit emotionally as well. In turn, as noted earlier in this study, this ultimately positively affects society.