Section 9 - Designing Your Clinical Experience with Purpose
The Guide for the Emerging Lactation Consultant
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The Emerging Lactation Consultant
A guide for preparing to be an IBCLC©, not just pass the exam.
Designing Your Clinical Experience with Purpose
The eight sections before this one were formation. You chose your pathway deliberately, you understood what the credential is, and you did the inward work: building an ethical practice philosophy, examining your hidden biases, and developing the research literacy, physiological grounding, and public health perspective that skilled care depends on.
This section is where that formation meets practice. Your clinical experience is where you stop preparing in the abstract and begin doing the work under guidance for the first time.
It may be helpful to remember how this guide earlier described the process of becoming an IBCLC in terms of “hard and soft skills.” Preparing to actually be a board-certified lactation consultant takes so much more than just meeting the requirements to sit for and pass the exam. Think of the requirements as the “hard skills”: the lactation-specific education, the health science knowledge, and the clinical hours.
The soft skills are what make you effective. Your ability to counsel someone, your approach to teaching people, your communication skills and methods — these are the building blocks of skilled lactation care. You may have acquired these in the process of earning your current qualifications or licenses. Clinical lactation care adds more to the equation.
Almost anyone could memorize some lactation facts and pass an exam. But the practice of skilled lactation care as an IBCLC isn’t about memorizing facts. We don’t tell our clients what to do, and in that way, we are pretty different from many other health care professionals.
We educate and offer suggestions, we teach clinical skills and techniques, we create plans with our clients for navigating their lactation journeys, and we provide encouragement and human connection.
Behind the scenes, we read and interpret research using critical reasoning and thinking skills, we apply and integrate knowledge about the current public health environment, and we endeavor to practice ethically and without conflicts of interest that would bias our care.
Skilled, clinical lactation care combines the ability to listen; to teach important skills that people need in order to breastfeed, express their milk, and feed their babies away from the breast; to give the right information at the right time in a manner that a person can receive it; and to communicate effectively, ethically, and responsibly with clients, the health care team, and the general public.
We have to remain open to new knowledge, new concepts, and new ways to help people. This humility sets us apart and allows us to work in relationship with our clients rather than as authoritarian figures.
Acquiring and practicing this particular set of skills is designed to be included in the work you are doing during the lactation-specific clinical experience portion of your exam preparation journey. By working with a mentor, you will have the opportunity to observe their abilities in the consult room, and you will develop your own as you begin to practice under their supervision. Their feedback will allow you to improve those skills over time, and by the end of your clinical experience hours, you should have demonstrated to them that you are a very competent counselor, educator, and consultant and that you can provide skilled, clinical lactation care with a global worldview.
This is especially important in the case of Pathway 1 candidates. As you noted in your plan back in Section 2, Pathway 1 does not supply the structure, mentorship, and feedback for you — that design work is yours.
If, as a Recognized Health Professional, you plan to obtain your clinical hours through your job or work setting or through independent clinical practice, here is how to transform your clinical hours into an experience that serves you AND your clients better.
Here I will outline some useful ways to make the most of your lactation-specific clinical experience hours, regardless of your Pathway or the setting in which you will be in contact with breastfeeding families.
Market your services clearly and ensure your clients understand that you are preparing to be an IBCLC, which means that if their lactation concerns or problems exceed your scope of practice or expertise, you will be referring them to a current IBCLC. (Keep in mind that the term “IBCLC” is not permitted to be used in any way by an individual who has not earned the credential.)
Define your precise parameters for referral to an IBCLC. This will likely be a big list of lactation situations and scenarios. After all, you are not an IBCLC, and if your client needs one, you have not yet qualified to provide that level of care. Creating your list of parameters for referral includes determining exactly how you will be learning from these cases: will you be able to accompany your client for their IBCLC appointments? Will you be communicating with the IBCLC directly about the care plan they create with the client? Will you be following up with the client after the IBCLC releases them from their care?
Identify at least one IBCLC with whom you can discuss clinical cases and questions. Include in your financial budget the expectation that you will pay them for their time, as they are providing you with a professional service that is part of your investment in learning and preparing for your IBCLC career.
Join (or create, if necessary) a small group of IBCLCs and aspiring IBCLCs — perhaps 8–10 people — with whom you can discuss lactation in general, career questions, and the like. A large online group of people you don’t really know is not the same as a small group environment where there is personal sharing, accountability to one another, and the free exchange of ideas and insights.
Schedule your support group observation sessions. There is no substitute for the learning you can do in a breastfeeding support group. Communicate with the facilitator in advance so that they are not surprised by your presence, and respect their leadership of the group. Expect to listen and learn only; you are not there to help or teach, and especially not to market your own services. Plan to spend some time with the facilitator immediately afterward or in the days following the group so that you can discuss what you learned, any questions that came up for you, and any insights the facilitator can offer. Keep in mind that many support group facilitators are volunteering in this role, so respect their time and offer to pay them for the time they spend mentoring you. Even if they refuse, they still might appreciate a donation for their group.
Use the clinical competencies document as a guide to check off lactation care skills and competencies you are acquiring over time. Alternatively, you could use it as a planner in advance by determining which types of encounters and lactation problems you need the most help with and including those in your parameters for referral to an IBCLC. The idea is to gradually gain confidence in each area by collaborating with an IBCLC and learning from their experience.
Take the time to invest in your own mindset by processing your own lactation experiences as well as your professional experience with lactating people and babies.
This is the work you began in Section 5. It is critical that you approach your work as a lactation care provider without bias or trauma leaking out of you in your encounters with new parents. It is common for an individual’s personal experiences or personal knowledge about lactation to lead them to pursue a career in lactation support, and this can also awaken an intense passion or enthusiasm for lactation.
You want that enthusiasm to work for you instead of against you. This doesn’t mean you should dim your light or keep your own story to yourself — it means you need to process it and package it in a way that serves your clients and audience with education, information, encouragement, and hope.
The value of you becoming an IBCLC is for you to combine and integrate the information, personal experiences, and professional expertise you already had with a strong foundation of knowledge about human lactation and how to provide skilled lactation care.
The flexibility of the process of becoming an IBCLC as set forth by the IBCLC Commission is that you design the specifics of your preparation, and in this way you build in the training you know you need to gain competence.
The responsibility is upon you to take the time to intentionally create a robust plan that will ensure that when you earn the IBCLC credential, you are ready and qualified to provide high-quality, skilled lactation care.
Add to Your Plan
This section asked you to design your clinical experience rather than simply accumulate hours; your plan should now hold the specifics only you can decide.
— Write your parameters for referral to an IBCLC: the situations and scenarios you will hand off, and exactly how you will learn from each one. Use the list of widest-gap areas you started back in Section 3.
— Name the IBCLC you will consult with, and add a line to your budget for their time.
— List the support groups you will observe, with target dates and the facilitator you will contact first.
— Note how you will use the clinical competencies document — as a running checklist, as an advance planner, or both.
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A note from Christine - This guide reflects my own perspective as a practicing IBCLC. I am not affiliated with the IBLCE or the IBCLC Commission and do not speak on their behalf. Always refer directly to the IBCLC Commission and IBLCE for current certification requirements. You can find official information at www.ibclc-commission.org.