Sarah Oakley BA (Hons), RGN, RHV, IBCLC, Cert HP (Open)

Nursing Nurture

What is a lactation consultant?

Lactation consultants are healthcare professionals who have successfully completed a 6 hour written examination (at degree level) and a substantial amount of breastfeeding counselling work (in my case over 2500 hours). In order to sit the exam, candidates must demonstrate that they have studied all aspects of breastfeeding including anatomy and physiology, endocrinology, biochemistry, nutrition, immunology and infectious disease, pathology, pharmacology, psychology, sociology, anthropology, research and ethics. As such they are the experts in breastfeeding and skilled in supporting all parents with breastfeeding, particularly those with more complex needs such as 

premature babies, sick babies, babies with disabilities,twins and other multiples, babies with poor weight gain, sucking problems, cleft palate and tongue tie.

Lactation consultants may have a background in medicine, nursing, midwifery or breastfeeding counselling. Some work within the NHS, some for the voluntary sector, some practice privately and some do a combination. Lactation Consultants are registered with and regulated by the International Board of Lactation Consultant Examiners. They have to demonstrate that they have kept their knowledge and skills up to date every 5 years and re sit the exam every 10 years to maintain their qualification.

Why employ an independent lactation consultant

Support with breastfeeding is available from a variety of sources – midwives and health visitors, peer supporters and breastfeeding counsellors, as well as from lactation consultants.

Breastfeeding is included in basic training for health visitors and midwives. However, the extent and depth of this training is highly variable. My own training included just 3 hours of breastfeeding education.

excellent grounding in normal breastfeeding and common issues associated with breastfeeding. However, it is not as in depth as breastfeeding counsellor training.

Breastfeeding counsellors train through one of the four breastfeeding charities within the UK – Association of Breastfeeding Mothers, Breastfeeding Network, National Childbirth Trust and La Leche League. All breastfeeding counsellors are required to have breastfed at least one baby for at least 6 months. The training takes place over a two year period and involves over 100 hours of study at under graduate level. Breastfeeding counsellors provide free support as volunteers via the national help lines, within groups and many offer home visits too. For more information see www.abm.me.uk, www.breastfeedingnetwork.org.uk, www.nctpregnancyandbabycare.com, www.laleche.org.uk.

Peer supporters are also mothers who have breastfed their own babies. They may receive training from one of the breastfeeding charities or from the NHS. Programmes of training vary but are typically around 12-16 hours completed over a period of 2-3 months. The training content varies but is usually similar to the UNICEF 3 day course. Their role is to encourage mothers to continue breastfeeding, provide information on normal breastfeeding and direct mothers to midwives, health visitors, breastfeeding counsellors and lactation consultants when difficulties arise. Peer supporters usually work in group settings, although in some areas they are encouraged to carry out home visits. They usually work on a voluntary basis, although increasingly the NHS and Children’s Centres are funding some peer supporter roles.

Health visitors, midwives, breastfeeding counsellors and peer supporters all have a vital role to play in helping mothers to breastfeed. However, the levels of knowledge, skills and experience among them are highly variable. Furthermore, getting timely help can be difficult due to the work pressures in health visiting and midwifery and the fact that breastfeeding counsellors and peer supporters are usually volunteers, are not available in all areas, and are not obliged to provide home visiting.

By employing a lactation consultant you can be sure that the information and support you get is of the highest quality, based on the latest evidence. Breastfeeding is the normal way to feed a baby. But, many misconceptions and myths still exist about it even amongst healthcare professionals.

Lactation consultants have the expertise to work with mothers and babies to establish and maintain breastfeeding in more challenging situations such as where the mother or child is ill, the child or mother has a disability, the child is premature, with twins or other multiples, or where the baby has sucking difficulties (e.g.: cleft palate), refusal to latch on or difficulty gaining weight.

As an independent lactation consultant I am free to work, within my code of conduct and scope of practice, in a flexible way to meet your individual needs. The number, frequency and timing of visits can be planned to suit you. You can obtain telephone advice 7 days per week between the hours of 9.00am – 10.00pm weekdays and 10.00am – 6.00pm at weekends. Where a problem necessitates a home visit this will be conducted as soon as possible after you call so breastfeeding difficulties don’t escalate and threaten your breastfeeding relationship with your baby.