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Episode 32: Alphabet Soup in Lactation Land: How to Find the Help You Need

, December 28, 2020

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Welcome back to another episode of The Breastfeeding Talk Podcast. I’m your host, Jacqueline Kincer. And I know that I’ve taken a bit of a hiatus from the episodes here. So for those of you who have been loyal subscribers, thank you so much for sticking with me here. And for any of you that are new, if this new, this is your first episode of the podcast, you’re listening to welcome, I’m super excited to have you. And hopefully, you become an avid subscriber. So I’ve got some awesome episodes coming your way some great, amazing guest interviews coming up for 2021.


So I’m really excited to bring those to you. And for those of you who follow me on social media, you might have seen me posts just been a lot going on in life. 2020 has been a crazy year. And so I did share some things going on with like family health stuff. And so thank you for all of you that have reached out and offered your prayers and well wishes it means so much to me and my family. So I just did want to thank you if you’re one of those awesome people out there. And if you’re like, What are you talking about? Don’t worry about it. But thank you so much for tuning in.


So this is an episode that I’ve been meaning to do for quite some time. And it’s it’s a topic that I want to approach very, very carefully, in some ways, because I definitely don’t want to offend anybody. But I also want to make sure that I’m bringing you guys the truth and the facts, so you can make a really good decision. So really, what this podcast is about is determining what how do you know what type of breastfeeding support you need? And where do you go get this support? So there’s a lot of people out there who could support you and breastfeeding. Right, so I’m going to kind of go through the list. You know, it could be a friend, it could be your partner, it could be a parent, it could be a sister could be a neighbor, it could be someone in a mom’s group, it could be something a little more professional beyond that, right?


And so how do you know, now everybody’s different, everyone has different needs, I’m not going to sit here and say that the second you have any kind of breastfeeding issue that you immediately need to go run and see an IBCLC. Okay, that’s not true. Not everyone needs an IBCLC. Now, what I will say, though, is that more often than not, people are are seeking under qualified people to help support them in breastfeeding, and they’re not getting the help they need. They go, they don’t go seek people with the proper qualifications, and then they’re breastfeeding journey is doomed, and they fail. So that’s very frustrating. So we want to make sure that you know, the level of support that you need, and where to get it and what each level can offer you. I will say, though, that this is a bit of a disclaimer here is that everybody’s different, right?


And every type of professional is different. So while I am an IBCLC, and there are lots of other IBCLCs out there, I have different levels of expertise in certain things than other IBCLCs have, you know, they have their own levels of expertise and things. So it could be, you know, number of hours that we’ve practiced years of experience, it could be additional advanced training, it could be additional credentials that we might have. So it’s not a one size fits all, all pediatricians, all lactation consultants are all the same. But I do want to address a big elephant in the room, which is the word lactation consultant. So this gets thrown around and it’s not used correctly most of the time. So what do I mean by that?


The only person who is technically allowed to call themselves a lactation consultant is someone who holds the credential of IBCLC international board certified lactation consultants. If you do not hold that credential, you don’t currently have it. You are currently not board certified by the IB LC which is our organization that board certifies us and does our examinations, checks our clinical hours all the things then you are not a lactation consultants. Okay.


So if you’ve had a lactation nurse in the hospital, but she’s not an IBCLC she’s not a lactation consultant. If you have someone you’ve worked with who is a CLC, which is a certified lactation counselor, you did not see a lactation consultants. A certified lactation educator is not a lactation consultant, a la leche league leader is not a lactation consultant. And believe me, it’s very disheartening, actually. But there are a lot of other organizations out there who have tried to create their own lactation certifications. Which certification is different than a credential by the way, but let’s not get too technical here.


And unfortunately, these people are not providing the same gold standard as IBCLC. They’re taking people’s money. Oftentimes, doulas, or sometimes it’s even, you know, nurses or, you know, other health care providers to kind of get like some add on, right, but it doesn’t, it doesn’t give you the right to do what a lactation consultant does. So here’s what I mean. So let me let me kind of run through these for you.


So an IBCLC, okay, it’s an international internationally board certified lactation consultants. Okay, so you need a minimum of 300 supervised clinical hours to and 90 lactation specific education hours, in addition to a lot of other educational requirements in the health sciences, okay to even be able to sit for your board exam, okay. And then you sit for your exam, and all of your stuff is reviewed, and you are either awarded, you know, the the IBCLC credential or you’re not.


So IBCLCs and this is the key word here, supervised clinical hours. Okay, so, and not everybody does this correctly, I’ll I’ll be totally I know people who have gotten people to sign off on their hours, and they have not done the work. Okay, so it’s very important that these are supervised clinical hours, meaning when you are getting your clinical hours to become an IBCLC, you’re not just shadowing somebody, you’re not just watching another lactation consultant work, you are actually those those hours are technically not allowed to count. It has to be you actually hands on clinically providing lactation and breastfeeding health care to a patient.


And you are being supervised by someone with a higher credential than you that is qualified to train you and supervise you. Okay, so that could be another IBCLC. It could be a physician, there’s various things that can be. Okay, so, the differences is that when somebody comes in IBCLC, they are now a healthcare provider. If they’ve had no other credential before this, they now have a credential that makes them a healthcare provider. Because their scope of practice as an IBCLC gives them the ability to work hands on and provide breastfeeding and lactation health care to the population that they work with.


Okay, none of the other certifications or credentials out there, qualify any of these other lactation people to be healthcare providers. So I want to make this very clear IBCLC as the only one that designate someone, a healthcare provider in the field of lactation. Any other alphabet soup behind someone’s name is merely someone who is a counselor or educator paid, they are not someone who was who has a scope of practice that gives them the ability to provide hands on breastfeeding or lactation health care, they should not be doing breast exams, they should not be checking babies for tongue ties.


They should not be, you know, dealing with breastfeeding pathologies, they shouldn’t be telling you how to treat damaged tissue on your nipples. They shouldn’t be telling you how to heal mastitis, they shouldn’t be doing anything. That would be considered as providing health care, the only thing we can do is to counsel you or educate you on the normal course of breastfeeding. And how you know when you’re not having a normal course of breastfeeding, and that they should then refer you to get helped by someone who can help you with that. So a CLC is a certified lactation counselor.


Okay, what what people do to get a CLC is they take a five day class, it’s 45 hours of continuing education. Okay, it’s classroom instruction. There’s no clinical hours. There’s no attendance at some sort of breastfeeding class. Okay, the CLC certification, the organization healthy children that puts this out. They don’t have any sort of regulatory authority for licensure. So some states actually do have licensure for IBCLCs others don’t. It’s a state-by-state basis just like anything else.


And really You know, this is this is just an educational, you’re certified lactation counselor, you can counsel people again on the normal course of breastfeeding. Now, I’ve actually seen the study guide that that goes along with this course and seen the curricula. It is very, very basic, it is very, very bare minimum, it is not at all, I would be terrified to see someone who has only a CLC certification out there trying to support or troubleshoot breastfeeding problems for a mother and their baby. That That to me would be a disaster.


Now, if breastfeeding is going well, but the mom is just like, oh, you know, I’m just struggling with, you know, just, you know, is this normal, you know, that my baby eats 12 times a day, I just feel exhausted. Maybe you should talk to someone like a CLC. And that CLC can inform you, yes, it is totally normal that your newborn eats, you know, that many times a day, sometimes more than that, you know, but if you’re feeling like, there’s something abnormal, I would listen to that mom got and go seek the advice of someone more qualified than myself. Here’s some warning signs to know when things aren’t normal with breastfeeding, but they’re not able to assess you and say, you know, that this is not normal, and you need help, like, like, unless, unless they’re saying, okay, you know, you have bloody nipples, okay, that’s not normal, you need help, okay, they could do that. But they shouldn’t be the one to actually provide you the help with that.


Okay, they’re operating outside their scope of practice, okay. And it’s important that we all adhere to that. So then there’s the Certified Lactation educator. So this is a CL, E, they get even less education, actually, which is kind of funny, because they’re the person who’s supposed to be the educator, right? Really all this is is like a certification that allows you to teach breastfeeding classes. Okay, so it’s 20 hours of instruction time, there’s four hours of what they call clinicals. It’s not really the same as what we get for an IBCLC.


But it’s four hours. So you’re supposed to go observe, basically. And you can get a course that’s offered as 45 hours through other organizations, but there’s no clinical component. So it’s, it’s very similar to the CLC. But really, it’s more focused on you know, how you can educate people about breastfeeding and lactation. Then there’s the CL EC, which is certified lactation educator counselor. So they’ve now combined all all of these sort of, you know, letters together. And it’s 45, continuing education credits, and four hours of what they call clinicals. Again, this is more just observation time, and it’s offered through the University of California, San Diego. This is meant to be a stepping stone program, where you first have to complete this in order to go into one of the pathways to work on your IBCLC certification.


So basically, it’s like the bare minimum that you would need to start being mentored by another lactation consultant to go after your IBCLC certification. So the problem is a lot of people will say, well just spend the money and take this CLDC course save some money, and I can call myself a lactation consultant. It No, you can’t, nope, it doesn’t know you’re just really there to be, you know, learn communication skills, how to educate people, and how to counsel them again, on what the normal course of breastfeeding is, and what it is not. That is it. So these are the three main ones, I honestly don’t even want to address a lot of the other ones. The other one I will address though, is a la leche league leader. While she League is a mother to Mother support group. It’s an international organization, I’ve been a leader and a member of Lola J League.


That’s how I got started on my journey towards becoming an IBCLC. And it’s a wonderful, wonderful organization. But you need to know that, you know, that anyone who becomes a leader does have some training, they have to actually pass basically an oral exam with some other leaders, they actually it’s a long process to become a Lalaji league leader, I would say much more than 45 hours is definitely what it took for me. There’s written assignments, there’s, you know, all sorts of things.


And then that gives them the ability to lead meetings or to answer the volunteer phone line to help mothers who have questions that are calling in. But they were very specifically trained where we you know, as a leader, you really don’t provide hands on help. You refer out to health care providers in the community, such as IBCLCs, or, or physicians or whoever it might be. But, you know, again, this is just more of a support group environment. So it’s, it’s support, it’s education. It’s it’s counseling, but it’s really just meant to be a mother to Mother support group. So what I loved about it is I could be a leader, I could volunteer my time. I could have my baby, I could be at a meeting I can be breastfeeding And we’re going to talk about like, you know why it’s important to start your baby on solid foods at six months.


So every meeting kind of has a topic. So that’s really what a lot that two week leaders role is, they’re not at all lactation consultants. That being said, there might be someone at a meeting, who is relatively clear who is also an IBCLC. That happens very often. However, they know and they are very clear on their role as a leader that when they are acting in the capacity of Allah to the leader, that they do not do anything to act as an IBCLC. During that time, so there, they have their logic leader hat on, they do not have their IBCLC hat on. In fact, if they’re going to refer you in IBCLC, it was a requirement that we give at least three names of IBCLCs every single time, you could put yourself in there as one, but you need to have two others. So it’s not like we’re just farming clients out of these meetings or anything like that. It’s a very ethical organization.


I’ve to say one that I was very proud to be a part of. So I did just want to make that very clear. Also, you know, if you’ve ever used the WIC program, the women Infants and Children program, they do have peer counselors there, they do have training, they must have been a WIC participant themselves, they must have breastfed for at least six months, they get 20 hours of on site training. That really covers again, the normal course of breastfeeding and human lactation, they get communication skills training, they do role play activities, things like that. And so they may work in those WIC clinics and be there for you as well. There are other organizations out there besides Lola T League, like breastfeeding USA, and they have counselors, again, it’s very similar to wallichii League, and things of that nature. Then there’s, there’s other you know, the Certified Lactation specialist. Again, this is basically the same as a CLC. It’s just a CLS. So it’s a 45, you know, our five day training homework, a final exam, that kind of thing. They’re certified breastfeeding counselors, CBC, this is from an organization called childbirth, international. And they give 30 hours of breastfeeding support training, it’s, it’s usually online. And they basically have to put together like a portfolio of local breastfeeding resources, and they complete a final exam. So there’s just, you know, there’s, there’s more. And again, I won’t really get into it, just because they’re all basically the same.


But the key to recognize here is that, you know, if you’re looking for someone where you’re like, I just want to know, like, I need some education about breastfeeding, maybe you’re pregnant, and you’re preparing, you know, or maybe you just had the baby and things are going well, but you just want to know what to expect. Right? Like, like, what, what should a normal day look like? You know, how should my baby be breastfeeding or behaving?


You know, throughout the whole time, you know, what do I need to know about breastfeeding, right, you’re looking for that, then go to one of these people, talk to a CLC, a CLE, CLE, see a CLS wallichii, league leader attend the wall, literally meeting, you know, so many of these people are doing, you know, virtual things these days, like a lot of us are because of the pandemic and whatnot. And it’s a great thing to have available any way when either you’re pregnant, or you have a newborn, because trying to go to places in person can be really tough anyway, right. But maybe you want to have that physical connections, there may still be some in person stuff happening. But those would be the resources for you where you’re like, you know, I just don’t know if this is normal or not. Or I just want to understand, you know, breastfeeding or lactation a little better. I want to know, like, what to expect those sorts of things, then you go to one of those people. But if you’re having breastfeeding problems,


if there is something going wrong with breastfeeding, and what I would put in the category of something going wrong would be like damage to your nipples, a baby that doesn’t latch a baby that’s not gaining weight appropriately. A baby that needs to be supplemented with something other than breastfeeding or you’re pumped milk. You’re not able to pump enough milk, you’re not able to make enough milk, you have thrush, you have a plug duck to have mastitis. Your baby is showing signs of food intolerances. You know any any of those things, right, your baby is not sucking properly at the breast, your baby’s not able to latch without a nipple shield, or you have to use a nipple shield part time even.


You’re having to use intervent having to pump not by choice, but because that’s what you need to maintain your milk supply or to get your baby fed but you would rather be feeding at the breast. Any of these kinds of things are really what I would call breastfeeding pathologies. And they need to be treated by someone who was a healthcare provider that can help you with that. In most cases, that’s going to be an IBCLC or at least an IBCLC may be part of your team. So meaning that perhaps the pediatrician involved, because the baby’s losing weight, and they want to keep an eye on that. And they may have some food intolerance issue. So they’re trying to work out, you know which formula is best for your baby.


And then alongside that your lactation consultant is helping you with increasing your milk supply and making sure you’re understanding pumping, not only how to operate the pump properly, which pump is best for you, how often to pump all those things, but they’re working in tandem with the pediatrician. Alternately, it might be also like an OB or midwife or something. And then maybe you have chronic clogged ducts, and you know, you’re going to them for treatment or medications or what have you. But you’re also working with IBCLC to figure out like, well, what’s the root cause here? Right? Is it just lack of adequate drainage of the breast? Or, you know, what is it the positioning of the baby and the latch technique or, you know, there’s something going on, right, maybe your baby has a tongue tie, okay, you don’t just go to the dentist or the pediatrician or the EMT, you who, whoever is going to treat it.


Because while they can fix the structural problem of the tongue tie or the lip tie, they can’t fix the feeding function of your baby, that’s something a lactation consultant does. And again, please know that when I say lactation consultant, I do truly mean IBCLC. So anything like that, where it’s, it’s a past ology that’s going on with breastfeeding, that is what an IBCLC is there for. And from the very beginning of IBCLC training, we are trained to work in conjunction with other health care providers to support you. Because as an IBCLC, I can’t prescribe you medications, okay, I can’t perform an ultrasound, I can’t release a baby’s tongue tie, you know, there’s certain things I can’t do. Right? There’s there’s other providers out there that can do those things. Just like a pediatrician, can only treat the baby, they can’t give you antibiotics for your mastitis. So now you got to go to the OB or your primary care or whoever.


Right? So we’re always everybody in healthcare is always working together as a team, or at least they should be if they’re needed. And so, you know, it’s it’s not like, like, unfortunately, you should never have someone who’s purely like a doula and like, let’s say a CLC. Okay, who examines you, gives you a care plan and sends a report to the pediatrician, they’re acting as an IBCLC, without the credential. And I don’t want to throw anyone under the bus here, I get it, you know, I get that there’s not really any real enforcement of this that, you know, people feel like because breastfeeding is something natural that, you know, we should all just be able to help each other with it. And again, you, you may just need help from a good friend, or a neighbor or family member, you may just need some informal mentoring and help much like any other medical condition. Right.


So if something you know, you get sick with a cold, you know, maybe you talk to a friend, and they say, oh, you know what I took, you know, huge doses of vitamin C all throughout the day, and that knocked my cold out even faster, and you go by the vitamin C, and you go take it at home, maybe you never even see your doctor about this. I’m not saying that anytime you have a breastfeeding problem, you must go see an IBCLC.


But what I am saying is that, let’s say you get sick, you try this vitamin C trick your friend gave you and you’re just getting worse. And now you’ve got a fever of like 104. And you’re like, Oh, my goodness, what is going on? While some of you might choose to just tough it out at home and spend time on the internet and research. Others of you might go choose to see a health care provider, you might be going to urgent care, call your primary care, do a telehealth, visit, whatever and figure it out. You might decide, okay, you know what, I really didn’t want to take the Tylenol, but I am miserable, I am going to try that. You know, and so whatever it is, you go seek out that care. So


you always get to decide when you want to bring in someone to help you with your situation. You may not want to bring in anyone to help with your situation, that’s totally your choice. But what I don’t want is for people to be deceived into thinking that all credentials and lactation land are somehow created equal. They’re not IBCLC equals health care provider, none of the other ones do. They’re there for education and support. That’s it.


Okay, now they those people who hold the CLC or CLE, or seal, you know, whatever, blah, blah, blah, the alphabet soups, they may also be a healthcare provider. But just because they’re a physical therapist or a pediatrician or an OB or, you know, a chiropractor or whatever, that doesn’t mean that they get to start doing things that IBCLC us do. It doesn’t give them that right. It doesn’t that’s not included in their scope of practice, right. So, so when a chiropractor goes chiropractic school, they’re not learning how to, you know, examine a baby’s mouth for a tongue tie. It’s not part of their training. It’s not that they can’t do that. But that’s going to be something that they they got some separate education on. So there’s some things that aren’t always certified or credentialed, if that makes sense.


Like, like, it’s not necessarily part of IBCLC training for us to do oral exams on babies. Now, it’s expected of us. But that we know how to do an oral exam. But not everybody does an oral exam and looks for tongue ties or lip ties, some people just do the oral exam. And they may look for a cleft lip or palate, they may just look at some sort of tongue function, you may have the baby stuck on their finger, everybody’s got a little bit different technique. So while I’ve done a lot of advanced training in everything related to tongue tie, and lip tie, and buckle ties and things like that, there’s not like a certificate that I walk away with other than for, like my continuing education credits. So it’s not like I put something after my name that says, you know, TTS tongue tie specialists like that’s, you know, and I think it’d be a sad day, the day that someone does that, because, you know, it’s every everybody in healthcare has a difference, like, like, if you’re a neurologist, okay, you might work with the brain, you might work with the spine, you might work with both the brain and the spine, but you don’t need to have separate letters behind your name, designating which specific part of the body you have the most advanced training in, right. So this is where you go to a provider’s website, or their social media, or you give them a call, or you send an email or whatever, and you get more information about what they specialize in.


Okay, so IBCLCs aren’t any different than that, you know, some, some know a lot more about herbs and milk production than others. You know, some, some are great with watching positioning than others, it just depends, right, and it’s going to vary based on the geographical location of your provider have their own personal experience a lot of the time, their own passions, right. So they may be very, very niche down, you never know. So you know, some IBCLCs work in the hospital, and they’re only supporting really, you know, new moms and you know, newborns within the first few days of life.


So if you’re struggling to wean your 16 month old, seeing a hospital IBCLC, who never works with a child who’s 16 months old, they’re probably going to be at a bit of a loss as to how to help you and tell you to go see someone else. Right. So that’s the point that I’m trying to make is that everybody’s got a different specialty. And so maybe you work with someone, and you didn’t really get the help you needed. That doesn’t mean that we all have the exact same training or clinical experience or skill set to offer you. Maybe you just needed to find someone with a different skill set. And that’s okay. So what I’m trying to say is that, you know, everybody’s in a different place, in terms of their training and what have you. What I don’t want to happen, though, is for anybody to say, I worked with the lactation consultants, and you know, they didn’t, they didn’t help me, because you didn’t actually see a lactation consultant.


So for any of the moms out there listening, or dads, if you happen to be listening, or if you’re another healthcare provider, trying to support, you know, breastfeeding or lactating moms, what I would suggest to you is, you know, if counsel the people that you’re working with counsel your clients, or your friends or your patients, and say, Hey, if you are having breastfeeding problems, okay, and something is going wrong, and you’re not sure what to do, make sure you see an IBCLC. So someone says, their lactation, and so on, they advertise that look for those credentials behind their name, we’re not shy about putting those there, folks, you shouldn’t have to hunt for it, if you have to hunt for it. Either this person just kind of forgot to put it out there, or probably they’re not actually an IBCLC. So and this isn’t like a,


an infomercial, you know, again, trying to sell you on getting IBCLC care. You know, some of you may do great with a book, some of you may do great with an online course. And so, you know, you may only need that level of support, you might just need an online moms group, you know, to just bounce things off of and, you know, all that kind of stuff, right? What I’m what I’m trying to impress upon you is that, you know, sometimes people just stop at a certain place, and then they never fully get the help they need. So meaning that they go to the pediatrician, the pediatrician says, Your baby’s not gaining weight appropriately. Here’s some formula, given this many ounces after every feeding, whatever, they may even tell you to pump, okay, and they send you home, but your milk supply is going down, down, down, down, down.


First of all, I do think that the pediatrician should absolutely be referring you to lactation consultants, but most don’t. Unfortunately, they don’t tell you why your baby’s not getting enough weight. They just he’s not getting enough milk or she’s not getting enough milk, here’s formula or go get formula. And they leave it at that. Well that’s a real disservice to you. And it can be a real blow to you because you can feel so inadequate in that moment. And you can feel like all you wanted to do you have this dream of like joyfully breastfeeding your baby and now that’s not happening and you’re panicking and you’re freaking out and you’re hyper vigilant, like, I need to make sure that my baby’s getting enough to eat and I’m not making an and you can feel like lots of a mom, you can feel guilt, you can feel alone, you can feel lost, right? And then you know, people say, well, thank goodness for formula.


But maybe you don’t want to give your baby formula. So what is the answer there, a lot of you will reach out and you will contact, you will find a lactation zone, you’ll contact one, you’ll start working with one, some of you wait a little bit of time, some of you aren’t even aware that we exist. And so and then in some of you say, well, a doctor should should know, right, a doctor would tell me if that’s what I needed. And I think there is that there is a subconscious assumption there that people feel like that, you know, someone who has, you know, an MD credential behind their name, that they are kind of this not necessarily all knowing person, right?


But, but that they would be giving you the best guidance. And so when they don’t refer you to an IBCLC, a lot of times, their patients are the parents of the patient, really, because the patient is the child or the baby don’t think that they should reach out for more help, because they’re not getting referred for it. So it’s, it’s kind of a hard thing. You know, some sometimes people feel like they’re sort of betraying their pediatricians trust when they go seek outside advice or counsel. And I don’t think that your pediatrician or your child’s pediatrician means it that way. Right? They’re just very busy, and they’re just trying to tackle the problem at hand. And sometimes, you know, they just just kind of don’t even think to mention that. So what I want to encourage you to do is go hmm, you know, maybe at least check in, right. You know, if you’re in the United States, most states have a 24 hour breastfeeding hotline, go to Google, look that up. You know, I know here in Arizona, you just go to Arizona Department of Health, you can find the breastfeeding hotline, someone always answers the phone, if they’re busy, and they can’t answer they’ll call you back, you call it 12:30am, they’re going to call you back or they’re going to answer or call wallichii. League, they have what’s called a warm line.


So it’s a free hotline, you can call your local voluntary leave chapter should have one. If not, there may be a national number that you can just look up and call and, you know, they can tell you, they can, they can see if it’s something they can help you with over the phone. Or they can say you know what I think you really need to see, you know, a doctor or a lactation consultant, or, you know, whatever this other specialist in your area, and they will have a list of resources they can give you that are trusted resources that they can pass along to you. So what I would encourage you to do is if you know something’s not right, or you have questions, and you just don’t feel like you have all the information, start low, start low on this hierarchy, you know, start with volunteer support organizations, or start with WIC, if you want to hire someone, a CLC, or CLE. And get yourself more education, if you just want to buy a book, if you want to buy an online course, you know, get access to more information. And then from there, you’ll either feel like you got what you needed.


Or you’ll realize, oh, I need I need a bit more, you know, some of you might just go right off the bat, like, I’m just gonna skip to the head of the line and go get myself an IBCLC. Great, that’s cool, too. You know, I always tell people, you know, they’ll say, Well, how often do you see, you know, low milk supply? Or how often do you see tongue ties or you know, you name it, whatever, fill in the blank problem. And I go every day, because I only see the people that have problems. So it’s very, very rare that people come to me when they don’t have problems. I have had those appointments, where people just kind of want to check on things and what have you and things are going extremely well. But those are few and far between.


So I do have a bias for sure. But you know what I want though, what I want is for people to not leave me. Truly, you know, that was one of the reasons why I do this podcast is I don’t want you to have to come running to an IBCLC for every little breastfeeding thing. Like if you just have a question about, you know, how many times a day you should pump while you’re at work from your baby, I’m more than happy to advise you on that. But you could really just go to someone who’s a CLC or a CLE. And pay less money and get that kind of advice. Right? Or you could read a book or you know, and I’m not saying I’m not saying don’t come to me with those questions, but what I’m saying is, is that it might be a bit of overkill, right? So know where you’re at know, if you just need education, if you just need support, or a combination of the two, or do you need like health care level advice and treatment? Do you need assessment, examination advice, treatment plan, care plan? If you need that you need the whole gamut, then come to an IBCLC if not, there’s some educators out there some counselors, you know, maybe even the pediatrician or your midwife or your OB or whoever your primary care is sufficient. Again, books, courses, that kind of stuff is not to be discounted.


Maybe it’s a product, maybe you just need a different brand of nursing pillow. Maybe you don’t even need anything else other than that, and you just you get that pillow and it’s a game changer and you’re like, Oh man, why didn’t I know this from the very beginning? Oh, I should have listened to those Amazon reviews, you know, so. So sometimes it’s a product. And there’s whatever supports you on your breastfeeding journey and helps you meet your goal. That is what you need. So if you’re finding that your need isn’t getting met, that you’re struggling to have the breastfeeding relationship that you want, that you feel like you still don’t have all the answers, then by all means, go out there and seek them.


This may be one of the reasons why you’re listening to this podcast right now. You know, I through books and courses out there, but I didn’t throw a podcast out there or a YouTube channel or, you know, social media account, right? There’s a lot of places for you to get information. The only thing I would say is, you know, I love that we have the internet and access to so much I do. I do think it’s great for you to start to get a feel for you know, getting your questions answered, seeking out advice. You kind of getting an idea of like, what’s normal, what’s not, and trying to get a feel for things, right, you’re trying to get sort of, we’re humans rights, you’re trying to get this collective information. we’re social creatures. So we want to learn from a collective, we don’t want to learn in a vacuum.


So we want to see well, how’s everyone else doing this? Okay, okay, so this is kind of normal, that babies just want to be held all the time. Okay. All right, I got it, you know, and then you read a book, and it kind of confirms that and you’re like, Okay, so, you know, you know, you’re learning, right? And then your brain is taking in this information. And sometimes it agrees with it, and sometimes it questions it, right, and then you make your own decision about it. The problem that I see people getting into, though, is that they think because there’s so much on the internet out there that they think that they can just get whatever they need for free, and that they don’t ever need to pay anyone to work with them to get their help. And that that strategy might work for a lot of people, but it doesn’t work for everyone.


And what I mean by that is, is that when I work with clients, I’m not just sitting there regurgitating a bunch of stuff that you could have Googled. Now, there are some lactation consultants who do that, especially in the beginning of their careers, because, you know, that’s what they feel most comfortable doing. Right. But when I work with someone, I’m doing something that no one on the internet can do for you, you know, the just a, an internet resource that you’re consuming, passively, right? I look at you and your baby, as a unique dyad. I look at your situation, I go through the history of your health, your baby’s health, breastfeeding, birth, all of it.


And I do a physical exam, I assess you emotionally and physically and health wise and all of that and your baby, I do the same. And there’s going to be a physical thing that we’re looking at, you know, function of, of you, your breasts, your baby, the latch, technique, the positioning all of that. And when I when I’m able to assess and examine all of those things, that I can figure out what’s going wrong. And I could tell you a lot faster than a Google search well, right so and then I can give you a treatment plan for fixing it. And the problem with stuff on the internet is that it’s a great baseline. Like if you’re just having minor stuff that you need to make some tweaks need a little help with this. Just trying to optimize things great. But it’s a one size fits all approach. And so unfortunately, what I have moms come to me is they’ll say, Well, I’ve tried everything, I’ve got the lactation cookies, and I’m drinking the Gatorade, and I’m doing this doing that I’m like, You’ve tried everything that you know how to do.


But none of those things are actually helpful for you. Right, so maybe they’re helpful for someone else, but they’re not helpful for you. And unfortunately, by the time a lot of people get to me, they’ve spent not just a lot of money, but a lot of time trying to troubleshoot things on their own. And then their self confidence gets killed. And they’re kind of just almost on the verge of ready to give up breastfeeding. And then they just give it all one last shot. By contacting me. Of course, I’m able to help and we can turn things around.


But I would just love it if I saw more of you just saving yourself the heartache, and the pain and the confusion and the self doubt and all of that, like just if you’re really struggling like that, if you find that every single day, you’re trying to get information about how to fix your breast feeding problems online, it’s time to hire someone just bite the bullet and do it. I promise you, you’ll be so much better off. And I think that, you know, as women, I see it culturally that we really have a hard time asking for what we need. We have a hard time asking for support. And it’s you know, we we have this baby that we’ve brought into the world, we want to be able to take care of it. We want to be able to provide for it right? This is very nurturing primal thing, but you don’t know what you don’t know. And so if you’re not able to figure it out on your own, it’s okay to bring someone else to help you figure it out. In fact, that would be doing the best thing for your baby. Right as opposed to stressing yourself out and you’re not getting your needs met and you can’t meet your baby’s needs. You’re just spinning your wheels trying to figure this out, let’s bring in an expert and get it figured out. Let’s just put an end to the misery and get you guys going to, you know, happy, healthy breastfeeding relationship.


That’s what I want to see for people. So again, I think it’s honestly, you know, not the majority of people that need an IBCLC or even need any sort of lactation helper, but just know what you need and know where to get the help. So one of the things I would recommend is, if you’re pregnant, if you have a friend who’s pregnant, get this going ahead of time, you know, get a list, right, have a list of all the things, you know, postpartum doulas, you know, pelvic floor therapists, you know, body workers of any kind, you know, besides pelvic floor therapist, lactation consultants, support group, get a good book on breastfeeding or, you know, parenting or raising a baby or what, you know how these resources ahead of time, you may not need them. But at least if you have a list, right, I’m not saying go buy the book, I’m not saying, you know, go hire the person right off the bat, but at least have a list. Research these people that you might potentially need, create a list, if you have a friend that who’s expecting this to be a great baby shower gift, quite honestly, that would mean a lot more to them than probably, you know, a package of diapers. So put together a list, take some time, even better, if you just you know, check the website social media profiles, even if you have a chance to just, you know, connect on the phone or email with this person and kind of like do a little mini interview really quick, just to see, no, I think it’s a really wise and prudent thing to do to prepare yourself to set yourself up for success.


So you know, I get it, most of us are probably last minute looking stuff up online. And, you know, it’s easier said than done, I totally get that. So no matter how you get the help that you need, as long as you get it in the end is what’s really important. So I just really did want to just, you know, take some time to clarify, what are the different levels of support out there? What, you know, what are, what are the ways that we can get the help and support that we need along are breastfeeding or lactating journeys? And you know, I guess, probably one last logistical question I’ll ask if it if it at all helps is that an IBCLC is really the only provider that does lactation, you know, standalone lactation, that is able to bill your insurance, whether they give you a super build, you then submit for reimbursement yourself, or maybe they’re in network or out of network, and they submit the bill for you.


They’re the ones that are technically covered, you know, by the Affordable Care Act. Now, that’s a whole other story about trying to get insurance to cover your lactation consultant, they have been a lot better these days about covering that. But if you see someone who’s not an IBCLC, who’s not a health care provider, your insurance is not going to cover that. So I just unless you have some, you know, awesome plan that covers non-health care stuff, which is, which is really, really rare. They’re not going to cover that. So I don’t ever want anyone to think oh, man, why didn’t I get reimbursed for my, my session with a CLC? Well, that would be why. So just just something I wanted to clarify there. So anyway, I hope that this episode was helpful to you in just deciphering the alphabet soup of lactation credentials out there.


And, you know, if you have any questions about some of these, you know, there’s a lot of good information online. There’s some great blog posts or posts from these professional organizations that you can see about, you know, what, specifically their scope of practices and dive deeper, if you’re thinking about becoming a lactation consultants, you know, I would say, you know, don’t don’t think that you’re going to be able to cheap it out by getting one of these lower, you know, certifications and calling yourself a lactation consultant, you’re not only doing the families that you work with a huge disservice, but you’re doing yourself a disservice. Really, you know, the investment to become a healthcare provider is is not, you know, less one of money than it is time, it does and should take a long time to become an IBCLC. And so, if you are not super committed to that, and you just want to provide some counseling or lactation education, then know that that’s, that’s what you want to go for, you know, you may go, you may get to that you may love what you’re doing, which is kind of what I did and decide, You know what, I want to do more of this, I do want to become an IBCLC.


And you work your way there slowly, but just know what you’re being sold on, you know, know that what you’re getting yourself into is, you know, do I want to be a healthcare provider or do I want to be someone who’s more of an educator or a counselor or support type of person? Do I just want to teach classes? Or do I want to like, you know, really help these moms and babies who are struggling, and it’s okay, not everyone wants to be an IBCLC It’s okay. You don’t have to be and like I said, not everyone needs an IBCLC sometimes you need someone you know,


you know, not not quite as highly qualified. So if If you know where you’re at, then you know where to get the help that you need. And, you know, I really just want everybody to feel supported. Again, you may not need this, maybe this podcast is enough for you, you know, maybe you’ve got a friend in your life who is able to share their journey, and advice with you. And that’s all that you need. And I hope, what I hope for everybody who’s listening is that you all have the support that you need, you know, first and foremost, that is, quite honestly, the most important thing. And when I say support, not just logistically, right, but emotionally, mentally, all of that, because it’s, it’s really what we need to, to thrive. Right.


So, you know, maybe mental health, right, you know, maybe maybe the problem isn’t breastfeeding at all, maybe the problem is, you know, your, your, maybe you had anxiety beforehand, and now you’ve got postpartum anxiety, it’s just really ramped up. And breastfeeding is just pushing you over the edge, you know, the time commitments, what’s expected of you, you know, all of that. And maybe it’s not a breastfeeding problem at all, you know, maybe it’s that you just need to, you know, see a mental health specialist about this, right, and they have their own whole list of different correct credentials and ways of helping you. So, you know, I don’t ever assume that, it’s always that you need an IBCLC. And by all means, like I said, I really would love to see it, where, you know, families just didn’t have this many breastfeeding problems.


I would love for you all, to just be able to support one another as peers. And I think that’s one thing that we have lost as our society has moved, the way it has, is that there’s a lot of individualism, right, there’s a lot of, of this idea that we have to pay for everything, right. And I know that there’s some backlash against that. And I would say that we just need to be wise about how we choose to, you know, use our finances, right. So I don’t ever want anyone to be taken advantage of and just be spending money willy nilly.


But the same time, I think you can go too far the other way. And if you’re always trying to barter or get something for free, you may not be getting the quality of support, or you know, product or whatever it is you’re seeking out that you deserve. So just pick that fine balance, figure out what level of support you need. And then I say just go for it. Just bite the bullet, go for it and get the support. Because you deserve it, you really do. So thank you so much for listening to this episode. If you found it helpful, I’d love for you to leave a review on iTunes. Those five star reviews definitely help us show up for other people like you who want to find this type of information on a podcast, and share it with friends send this episode to a friend feel like it’s something they need to hear. And I would love to hear from you.


So if you want to reach out to me in any way, Instagram is an awesome way to do that. So go to Instagram, my handle over there as holistic lactation, comment on my post, feel free to send me a direct message. And I love to hear from listeners. So, you know, tag me in one of your stories reach out to me, let me know if there’s anything you want to hear about on this podcast in particular, and I will see you on the next episode.

In today’s episode, Jacqueline Kincer IBCLC is exploring the definitions and differences in the various lactation/breastfeeding certifications and credentials. All too often, families are told they are working with a “lactation consultant”, but unfortunately that doesn’t mean they are always seeing an IBCLC. Listen to this episode to understand the differences between IBCLC, CLC, CLEC, CLE, and more of the alphabet soup of lactation credentials!

In this episode, you’ll hear:

  • Which lactation credential designates someone as a healthcare provider
  • What the difference is between counseling and consulting
  • How to know which type of provider to seek out depending on your situation