More About Why Mothers Aren't Meeting Their BF Goals
More About Why Mothers Aren't Meeting Their BF Goals
The role of the IBCLC has evolved to include, among many other responsibilities, that of assisting a mother in assimilating the information she has gathered from literally hundreds of sources to make feeding choices for her baby. - multiple recommendations for duration of breastfeeding from official sources- range of public opinion/reaction- cultural bias- marketing of infant foods and products- mainstream media portrayal of babies, parenthood, infant feeding- ever-changing internet search information; not always credible- magazines/books with less current/updated information- Identifiable crossroads for mothers (i.e. growth spurts, milk supply changes, nipple soreness, return to employment, timing/resuming of hormonal birth control methods, etc.) and unpredictable crossroads (i.e. family pressure to wean, unexpected pregnancy, influence of marketing, infant or maternal illness, poor medical advice regarding bf or weaning, etc.)- IBCLC is trained to assess, evaluate BF and take into account additional factors as a counselor; helps mother sort through conflicting messages and make decisions- IBCLC trained to assist mother in evaluating current situation, account for long-term consequences of choices, refer to appropriate allied hcp's (i.e. in cases of postpartum depression, infant requiring additional medical evaluation, mother with symptoms of breast infection, etc.)- IBCLC responsible to provide current, unbiased, evidence-based information from credible sources and prohibited from marketing infant products - unique requirement of the profession, not required of physicians, store owners, internet website founders, etc.- growing number of preterm and late preterm birth presents unique challenges to mothers with regard to requirements for additional bf support and information specific to that population- growing number of mothers with multiple confounding health issues which affect bf require population-specific assistance There are many reasons a new mother might not reach her breastfeeding goal; some are simple and have easy solutions, but others have layers and are definitely more complicated. A healthy mother of a healthy, term newborn likely needs simple BF support: the proper information provided consistently, maybe a little help with latch and attachment, and continued support and help from her family as they transition into a new phase of life. An obese mother of a late preterm baby born via cesarean likely needs more than that. A 17-year old new mother likely needs more than simple BF support and education - she might need help teaching her mother, the co-caregiver for her baby, the same BF education that was just provided to her. The mother of multiples who were born preterm after invitro fertilization is likely to need more than basic BF support. So to say that mothers don't reach their goal of breastfeeding for x number of months is not to say that they are not trying hard enough. It is more accurate to say that mothers need highly varying amounts of breastfeeding support from multiple sources over the entire amount of time they intend to breastfeed. Modern mothers wake every day to face a veritable onslaught of advice and information about their baby - much more, in fact, than their counterparts even 15-20 years ago. In addition to the fictional families on TV, the women's magazines, the doctor's advice, and the infant formula marketing campaigns (yep, those were around then, too), today's mother also checks her email inbox multiple times per day, where she receives email newsletters chock-full of information and marketing about her baby's age and expected needs, email advertisements for things she might want to buy for a baby of this age, Facebook posts of things her peers and family are doing for their babies and families, and reality TV where babies and children are often treated as props and seen only when convenient to the "plot." Assimilating the information, well-intentioned advice, and peer-recommended practices into her actual mothering experience is overwhelming. The range of suggestions and ideas from other breastfeeding mothers alone can be intense. However, there is an oasis in the sea of conflicting messages: the IBCLC. When it comes to making progress toward a breastfeeding goal - ANY breastfeeding goal, an IBCLC is the person who can help a new mother navigate through the confusing parts to reclaim her vision and possibly even alter her version of what breastfeeding success means. Many a mother has consulted an IBCLC expecting to be told to push through the pain or just figure out a way to pump more often at work but leaves having been handed "permission" to give her sore nipples a rest for a few days while she pumps or to reconsider her baby's need for a certain number of ounces of breastmilk when he's already eating solids. Armed with information tailored to her personal situation, the mother walks away with a new ability to advocate for herself and her baby when she sits back down in her nursing chair at home. An IBCLC helps a mother to sort through what she's heard, think about what she's experiencing, and consider where she wants to go from there. There are identifiable crossroads where mothers can be expected to have questions about how to continue breastfeeding: when encountering pain, increased frequency of breastfeeding, need to begin pumping when returning to outside employment, when resuming sexual intercourse and needing to use birth control, and other predictable events in the postpartum period. Most of these predictable events can be navigated with appropriate breastfeeding education provided by a trained individual such as a La Leche League Leader, WIC peer counselor, or Certified Lactation Educator. There are also some crossroads for mothers which are more complicated and less predictable: a mother whose pediatrician has discussed with her that her baby is not gaining weight appropriately for age, a mother who has unexpectedly become pregnant while nursing her infant, or who has become ill and requires treatment or medication, and many others. These situations are easily recognized by the previously mentioned breastfeeding supporters and are routinely referred to IBCLC's. IBCLC's are uniquely trained to provide specialized breastfeeding assessment and evaluation and assist mothers with maintaining their milk supply when other confounding factors exist. In turn, as IBCLC's receive referrals, they also are responsible to refer mothers and babies to other healthcare professionals when appropriate, such as when symptoms of infection or postpartum depression are evident, or in cases where coordination with mother's or baby's physician would facilitate optimal care, such as when mother has a diagnosed hormonal insufficiency which is affecting her milk supply. Statistics tell a dreary story of mothers and babies and breastfeeding "success." The reality of mothers and babies in 2012 is that they live amidst multitudes of messages. Positive or negative, these messages affect the breastfeeding relationship in ways that science will never truly quantify. However, the IBCLC affects the ability of a breastfeeding mother to achieve her own personal breastfeeding goals on an individual level, and in the end, that is what is most important to that mother and that baby.