Lactation Management Training: From Novice to Expert

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We’ve come a long way, Baby!

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(Addressing the Healthy Beginnings Partnership of Greater Prince William VA & Alexandria VA Breastfeeding Promotion Committee celebration, April 7, 2015)

There is a perspective you achieve having been in the lactation field for most of a career; for me it has been more than 30 years.  I took the IBLCE certification exam the first time it was offered, in 1985.  Back then there were no pre-requisites, just a desire to offer breastfeeding support.  Eat your heart out - those of you who are taking 90 hours of training and hundreds of hours of clinical practice!  But the changes have been good for the profession as there is so much more to know now, and we hit the ground running as a new IBCLC with a much better background.

Thank you to the La Leche League Leaders here who kept the torch burning during the years when breastfeeding rates hit their low point and the medical professionals were seduced by the claims of the artificial baby milk companies.

We have since developed organizations to foster information sharing and program collaboration; The International Lactation Consultant Association (ILCA) and the United States Lactation Association (USLCA) for lactation consultants.  The Academy of Breastfeeding Medicine (ABM), is specifically for physicians.

We have international organizations also working to promote breastfeeding and limit the use of artificial breast milk worldwide.  The World Alliance for Breastfeeding Action (WABA) promotes World Breastfeeding the first week in August each year.   And the International Baby Food Action Network (IBFAN) keeps track of compliance with the World Health Organization Code of Marketing of Breastmilk Substitutes.  The “Code” limits the marketing of artificial baby milk.

The Baby Friendly Initiative has made huge strides in promoting the hospital conditions that promote the successful initiation of breastfeeding.  There are now 250 hospitals designated as Baby Friendly which amounts to about 12% of babies being born in “ideal” breastfeeding circumstances.  So there is certainly work to be done here as more hospitals address their policies and procedures to improve breastfeeding support.

The Office of Women’s Health (part of the Federal Government’s Health and Human Services) has primarily supported employed breastfeeding mothers and encouraged employers to provide facilities and time to enable breast pumping at work.

The Centers for Disease Control (CDC) has developed a “Breastfeeding Report Card” benchmarking policies and procedures in hospitals.  This allows administrators to compare their services and outcomes to other hospitals in their state and the nation.

Back in the day, we used to lament that there was no research on breastfeeding issues.  That has certainly turned around.  Now there is so much lactation related research in so many health science journals, it is hard to keep up.

Breastfeeding Coalitions, sponsored by the United States Breastfeeding Committee and the CDC, are active in all states and sometimes several coalition and workgroups are active in an area.  I congratulate you in your efforts here in Northern Virginia to expand breastfeeding advocacy and support.

Laws ensuring the right of a breastfeeding mother to feed her baby in any public place have been enacted in almost all states.  Congratulations to you for moving this through the Virginia legislature.

So, over the past 30 years, there have been tremendous changes in the breastfeeding landscape that is gratifying to see.  I am sure I have not mentioned all of the groups involved or activities of concerned professionals.  When you have a bad day, you encounter an “uneducated” health professional or a breastfeeding mother who did not receive the support she needed at the time she needed it, just think about all the improvement that has occurred over the past 30 years and keep the faith.  Working together we are making progress!  

Vergie Hughes has a long history of experience in Maternal Child Health including labor and delivery, post-partum and pediatrics, and for the past 25 years she has been involved in lactation management. Ms. Hughes has a BSN from Pacific Lutheran University and a MS from Georgetown University. She has been a board certified lactation consultant since 1985. At Georgetown University Hospital, she was the director of the Human Milk Bank. She created and developed the National Capitol Lactation Center and the one week Lactation Consultant Training Program. This course has trained more than 4,000 Lactation Consultants since its inception in 1990.


She has been a private practice lactation consultant and business owner, and operated her own lactation center, Washington’s Families First. Lactation Education Resources On-Line is her website, offering training to professionals and information to parents as well. Ms. Hughes has served on the International Board of Lactation Consultant Examiners and has served on the IBLCE exam writing committee. Her first love is teaching and that is exemplified by the creativity of the courses she has developed. A series of courses “The In-patient Breastfeeding Specialist,” "The Out-patient Breastfeeding Specialist” and “The NICU Breastfeeding Specialist” are all designed to advance the lactation management skills of nurses at the bedside. She regularly teaches skills to labor and delivery nurses and just recently developed the course “Towards Exclusive Breastfeeding.”


Ms. Hughes is the program director and content manager for all of the on-line Lactation Education Resources courses. Ms. Hughes was recently honored with a “lifetime achievement award” as Fellow of the International Lactation Consultant Association (FILCA).

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