Lactation consultants support new nursing mothers
Sunday, February 01, 2004
Most hospitals offer the service these days By Alice ChangOne source of breastfeeding information is the La Leche League International's hotline, (800) LA-LECHE.
When Mary Ferolie breast- fed her newborn two years ago, her nipples were sore for a month. "I think everybody thinks it's normal to be sore when you nurse, at least for a couple of weeks," says the Geneva mother.
But with the birth of her second child two months ago, Ferolie hired a lactation consultant to give her instruction during her first breastfeeding session shortly after giving birth.
"She positioned the baby, kind of observed us a few times and would give me little techniques," Ferolie says. "This time I was not sore and the baby was nursing great. He gained 3½ pounds within the first month."
Ferolie is one of thousands of new mothers in the Chicago area who see breastfeeding specialists every year. There are no official figures on how many women use these services, but 10 years ago about half of Illinois hospitals offered breastfeeding specialist services. Today about three-quarters do, according to Jan Barger, who has 18 years experience and is one of Chicago's most senior internationally board certified lactation consultants.
There are several types of breastfeeding specialists:
• Lactation consultant. This is a general term for people who give advice about breastfeeding. Their level of training and experience vary greatly, from no training to the rigorous preparation of those who are internationally board certified. These women generally charge for their services.
• Internationally board certified lactation consultants. These consultants undergo rigorous training that includes at least 45 hours of lactation management and they take a six-hour board exam. Internationally board certified lactation consultants charge between $65 to $250 per visit for sessions that last up to two hours.
• La Leche League International leaders. These women are members of a nonprofit group of mothers who support breastfeeding. Leaders have extensive mother-to-mother training from the league and personal experience in breastfeeding. Most women volunteer under the supervision of another leader for a full year before they work independently. These women answer questions by phone and host monthly meetings; they provide free services.
• Breastfeeding peer counselors. These women generally work with lower income or minority women. Most are trained through a 20-hour course offered by La Leche League or the federal program, Women, Infants and Children. These counselors offer their services for free.
If a mother needs emotional support or education, she can see a peer counselor or La Leche League Leader, says Mary Lofton, a spokesperson for the league. If there is a more serious medical condition, Lofton suggests the mother see a board certified lactation consultant.
"Your best bet [for finding a private lactation consultant] is through a hospital or pediatrician," says Barger, who practices at Wheaton Pediatrics in Wheaton. "Ask for a referral and say you want a home visit."
A mother can also find a local internationally board certified lactation consultant online at the International Lactation Consultant Association Web site, www.ilca.org. To find out whether a lactation consultant is internationally board certified, check the International Board of Lactation Consultant Examiners Web site, www.iblce.org/.
There are about 250 La Leche League leaders and 340 internationally board certified lactation consultants in Illinois. Many Chicago-area hospitals have breastfeeding staff or volunteers. Most of these programs started in the mid-1980s, when patients began to request the service.
"We had a generation in the 1960s and '70s who were steered to bottle feeding," says Carol Chamblin, a board certified lactation consultant and president of Breast 'N Baby Lactation Services Inc. in St. Charles.
Nationally, breastfeeding rates at birth increased about 30 percent from 1991 to 2001, according to Ross Labs. The most recent figures show 69.5 percent of American mothers breastfeed at birth, but only 32.5 percent breastfeed by six months.
Charlotte Johnson, breastfeeding coordinator at John H. Stroger Jr. Hospital of Cook County, credits the overall rise in breastfeeding to heightened awareness.
"Women are getting more information prenatally," Johnson says. "There's more emphasis on the African-American population, which has the lowest breastfeeding rate. We're educating women-especially teens-a population that doesn't normally breastfeed."
Hospitals that offer lactation consultants generally offer the service to every new mother. Delivering one's baby in a hospital often complicates breastfeeding because of the separation of the mother and child, says Johnson. However, Barger says rather than allow the baby's first feeding to be formula, mothers can request to breastfeed.
Lactation consultants with private practices often offer home consultations. Most health insurance policies cover in-hospital visits, but only some cover home consultations.
Barger says her clients' top three complaints are lack of breast milk or low weight gain in the baby, sore nipples and failing to get the baby properly attached to the breast.
To treat low weight gain, Barger starts by taking a history and checking the mother's breasts and the baby. She then weighs the baby before and after a feeding. Afterward, Barger pumps the mother's breast to measure if there's milk left over. If the problem is milk supply, Barger recommends herbal remedies or asks a doctor for a prescription to help the mother produce more milk.
Barger says sore nipples are generally caused by the baby's improper attachment to the breast. Plugged ducts or a yeast infection can also cause the problem. If it's an attachment issue, Barger helps the mother position the baby correctly.
Reasons to see a breastfeeding specialist
• Pain while breastfeeding
• Newborn nurses fewer than eight times in 24 hours
• Baby has consistent difficulty waking up for feedings
• Baby has jaundice
• Baby is not gaining weight without supplementation
• Mother's milk supply is inadequate or overabundant
• Plugged breast duct or breast infection • Premature baby
Alice Chang is a graduate student at the Medill School of Journalism and writes for the Medill News Service.