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IBCLCs' perspectives on the diverse roles of healthcare providers in breastfeeding support

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Erica Hesch Anstey, PhD, CLC , Department of Community and Family Health, College of Public Health,, University of South Florida, Tampa, FL
Ellen Daley, PhD , Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Martha L. Coulter, DrPH MPH MSW , Department of Community and Family Health, University of South Florida, College of Public Health, Tampa, FL
Kay Perrin, PhD, MPH , Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL
Cecilia Jevitt, CNM, PhD , Yale School of Nursing, Yale University School of Nursing, Orange, CT
Sharon Dabrow, MD , College of Medicine, University of South Florida, Tampa, FL
Lynne Klasko, MPH , Tampa Bay Community Cancer Network, H. Lee Moffitt Cancer Center, Tampa Bay Community Cancer Network, Tampa, FL
Background: Breastfeeding women encounter many healthcare professionals who have a range of training in evidence-based breastfeeding practices and varied roles in providing breastfeeding support. Women who receive support from IBCLCs have better breastfeeding outcomes (duration/exclusivity). Understanding various provider roles in breastfeeding support is critical for providing optimal care in an interprofessional context.

 

Purpose: 1)understand how IBCLCs perceive the roles of various healthcare providers in the delivery of breastfeeding support. 2)determine how these roles impact the IBCLC’s role.

Methods: Following a grounded theory methodological approach, semi-structured interviews were conducted with 30 IBCLCs across Florida working in several settings (hospitals, WIC clinics, private practice, and pediatrics).  Data were digitally recorded, transcribed, and analyzed in Atlas.ti. Symbolic interactionism was applied as a guiding theoretical framework. 

Findings: IBCLCs perceived their role as multifaceted.  Six emergent themes were: 1)educator, 2)breastfeeding expert, 3)healthcare team member, 4)emotional support, 5)holistic approach, and 6)empowering mothers.  Themes for ideal roles of other providers included 1)basic breastfeeding knowledge, 2)support mothers, 3)know when to refer, 4)anticipatory guidance, and 5)communication liaison.  Themes related to actual role impact were: 1)respect hierarchies, 2)“We’re board certified, but that doesn’t mean anything,” 3)providers are influential, 4)damage control, and 5)role strain/conflict.

Discussion: IBCLCs were influenced by the enactment of various providers’ roles. Confusion about the IBCLC credential and issues of respect within the organizational hierarchy are problematic for some IBCLCs who approach breastfeeding support with a team mentality that is not reciprocated by other providers. However, IBCLCs have the potential to bridge disciplines and optimize breastfeeding support.

Learning Areas:

Other professions or practice related to public health
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify the perspectives of IBCLCs on their role and the role of various other providers in breastfeeding support Explain how various provider roles impact and challenge the IBCLC in providing optimal breastfeeding support

Keyword(s): Breastfeeding, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was PI on this research study and have worked on several research studies related to breastfeeding during my doctoral program. I conducted this research from conception, through data collection, analysis, and completion as my dissertation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3081.1: Breastfeeding Forum Poster Session