Lactation consulting: The expanding role of IBCLCs in breastfeeding support

The CDC recognizes professional support as one of six primary evidence-based interventions to meet Healthy People breastfeeding goals, and tracks the number of International Board Certified Lactation Consultants (IBCLCs) per 1,000 live births on their Breastfeeding Report Card. The Surgeon General's 2011 Call to Action to Support Breastfeeding assigns IBCLCs a prominent role: one of the 20 actions is to “ensure access to services provided by” IBCLCs. The profession of lactation consulting is only 26 years old, however, and only a handful of studies focus on the IBCLC. This study examines the challenges and benefits of working in this relatively new role in the health care team from the perspective of practicing IBCLCs. Methods: Qualitative, in-depth semi-structured interviews were conducted with 25 IBCLCs about their practice and their perspectives on the profession. Interviewees were recruited to reflect the diversity of the profession—they worked in hospitals, public health clinics/WIC offices, pediatric practices, and private practice. While many came from a medical background (including 12 nurses and 5 MDs), 8 came from non-medical backgrounds. Results: IBCLCs face numerous challenges in the workplace. IBCLCs note that the credential is not recognized by patients, is not always respected by other health professionals working with mothers and babies, and is often not valued by institutions such as hospitals and public health agencies. On the other hand, IBCLCs find the work they do to be highly rewarding and necessary, given the lack of breastfeeding knowledge and expertise among other health professionals. Conclusions: Understanding the role of IBCLCs in breastfeeding support, as well as the difficulties they face in practice, is important in meeting public health breastfeeding goals. The findings from this research can inform initiatives to increase the number of IBCLCs to the recommended levels, ensuring that parents have access to services provided by IBCLCs.