IBCLC practice: A unique approach to professionalized breastfeeding support

Historically, breastfeeding support was the informal work of family and community members. Today, breastfeeding support is also located in the biomedical system, where it is provided by the International Board Certified Lactation Consultant (IBCLC). The CDC and U.S. Surgeon General recognize the IBCLC's key public health role in improving breastfeeding outcomes (Shealy et al., 2005). While studies of women's perceptions and experiences of professional breastfeeding support have shown that women view effective breastfeeding care as facilitative and compassionate rather than disconnected and reductionist (Schmied et al. 2011), IBCLC practice has not been studied. The purpose of this study was to explore IBCLC knowledge and practice to understand their approach to providing breastfeeding care. Methods: In-depth, qualitative interviews with 30 IBCLCs, and clinical observations of 3 IBCLCs, provided insight into the daily practice of IBCLCs working in different settings—hospitals, WIC clinics, pediatric offices, and private practice. Results: While IBCLCs apply clinical experience and medicalized knowledge about breastfeeding and human lactation, their interactions with clients are compassionate, empowering, and humanistic, and are derived from nursing and mother-to-mother breastfeeding support models rather than from a technocratic, biomedical approach to care. IBCLCs spend time, build collaborative relationships, and share information with clients. Conclusions: This study demonstrates that combining medicalized knowledge with a mother-to-mother support approach to care matches the type of professional breastfeeding support that women experience as most effective. Employed at a larger scale, this unique clinical practice model has implications for improving breastfeeding rates in the U.S. and globally.