Lactation Management Training: From Novice to Expert

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The International Board of Lactation Consultant Examiners (IBLCE) has announced their plans for a new lactation support credential. The IBLCE is the organization that currently offers the certification credential for lactation consultants, the gold standard in lactation credentials, the IBCLC. The new credential will provide;

  • a credential for those who do not wish to pursue the full requirements for IBCLC certification
  • a stepping stone for those who seek a credential they can use for employment until they qualify for the IBCLC certification

This new credential will hopefully consolidate the many lactation credentials that are currently being offered by various groups. The United States Lactation Consultant Association has compiled a current list: Who’s Who in Lactation.
http://uslca.org/wp-content/uploads/2017/07/2-page-Whos-Who-updated-July-2017-Watermark.pdf


This plethora of course credentials is confusing for those aspiring to this field, as well as employers. With training at various levels, it is impossible for national organizations and health ministries who would like to measure the efficacy of breastfeeding services offered by those with differing levels of education and clinical experience.


In 1985, the IBLCE 1) developed a criterion-referenced examination for lactation support providers around the globe based on practice analysis survey (also known as a role delineation study), 2) defined clinical competencies and a scope of practice and 3) administers an accountability system for maintaining quality care. A similar system will be set in place for the second credential. One uniform testing organization will allow the standardizing of content of the curriculum taught to match the skills necessary to be a lactation support provider at both levels, current and proposed. The evidence demonstrates that integrated lactation care, provided by the appropriate provider, will help families meet their goals. The evidence also shows that skilled care provided at the time it is needed will improve national goals for initiation, exclusivity and duration.


There are situations and practice settings where access to an IBCLC is limited. Community health workers, peer support counselors, prenatal lactation educators, hospital bedside care providers all play a role in breastfeeding support. ALL lactation support providers deserve recognition of their education and competence to provide a standard of care which will support breastfeeding families. A global exam and credential created and managed by an organization which has done this for the past 30 years, is a benefit to those who want to provide service at a level below that of the IBCLC.


There are many for whom the IBCLC is out of reach due to the un-availability of training, cost of the college courses and lack of mentors available for clinical training. A entry-level credential will likely meet the needs of many world-wide.


Some are concerned and confused by the new credential. It was reassuring to see IBLCE listening to concerns at the ILCA conference and promising they will continue to dialogue with all stakeholders including IBCLCs, training organizations, government agencies, and health ministries. The creation of a new credential is a process and will not happen overnight. LER supports the IBLCE in their efforts to follow the process to bring a new credential to the landscape of lactation support providers.

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Lactation Education Resources has conducted it second annual Scholarship competition and we are pleased to congratulate the winners!

Drum roll here please………….

Shlonda Smith  Augusta GA

“After obtaining my IBCLC, my goal is to help all moms with breastfeeding support with a special emphasis on protection/promotion/support among women of color.  My goal is to continue working with low income women normalizing breastfeeding.”

Angie Natero  Dover, TN

“I am so thankful for this scholarship, and my goal is to use my future certification to become a lactation consultant, which will allow me to hopefully help many moms and babies have the most successful breastfeeding experience as possible.  Angie will be the only IBCLC in her hospital and in her area.”

Josephine Silversmith  Gallup NM

“I am a nurse working at the Indian Health Service Hospital.  I will be better able to help moms with difficult situations.”

Megan Kahlich  Hereford TX

“I would love to normalize breastfeeding among my staff and patients.”  Megan will be the only IBCLC in her hospital.

Tamika Simpson  Moreno Valley CA

“I plan to work with and support pregnant and parenting teens at Planned Parenthood and WIC in Orange and San Bernardino Counties and educate them on the importance of breastfeeding.”

The winners were selected on their commitment to work in breastfeeding support positions in underserved areas as well as their commitment to breastfeeding mothers and babies.  In addition, their previous experience, previous education, how involved they  are already in their community protecting, promoting and supporting breastfeeding, was considered.

Best wishes to these women as they begin the training to become an IBCLC!

Cymbal crash here…..

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I just got home from the AWHONN conference in Orlando.  We heard speakers talk about their plans to have an all IBCLC staff on their maternity units.  Now that is an exciting idea and what a great benefit for all of the breastfeeding mothers.   Expert help, at hand, whenever needed!

Other speakers talked about a mix of skills.  Some Breastfeeding Resources Nurses, some IBCLC’s.  But these managers recognized that everyone needs to have beyond the basics of lactation management training.

Recommendations from USLCA (and endorsed by AWHONN) have calculated the following recommendations for IBCLC staff:

Tertiary Care Facility (Based on 20% preterm delivery rate) - 1.9 FTEs/1000 deliveries

Hospital with Level II Neonatal Service - 1.6 FTEs/1000 deliveries

Hospital with Level I Neonatal Service - 1.3 FTEs/1000 deliveries

 The Joint Commission Accreditation Surveys now include Perinatal Core Measures that every hospital over 1,100 deliveries per year must monitor.   Through experience with high preforming hospitals, the Joint Commission believes that hospitals can achieve a 90% exclusive breastfeeding rate.  As more and more hospitals adopt the Baby-Friendly Hospital Initiative, they also are challenged to improve exclusive breastfeeding. 

The role of the hospital IBCLC is not only to provide care to breastfeeding mothers wherever they are in the hospital (maternity, pediatrics, emergency suite, surgical or medical units), but to train, coach and motivate the rest of the nursing and medical staff.  The other key role for the IBCLC is to influence unit policy and procedures.  The best way to improve breastfeeding exclusivity is to have an abundance of staff well trained in lactation support. 

In order to meet the mandates to improve breastfeeding initiation and duration rates, it is imperative that expert lactation support be readily available during the hospital stay.  The best way to achieve this is with an all IBCLC staff!

References:

AWHONN  Guidelines for Professional Registered Nurse Staffing for Perinatal Units.2010.  p.31

http://www.ilca.org/files/USLCA/Resources/Publications/IBCLC_Staffing_Recommendations_July_2010.pdf.  Accessed July 2014.

https://manual.jointcommission.org/releases/TJC2013A/PerinatalCare.html.  Accessed July 2014.

https://www.babyfriendlyusa.org/about-us/baby-friendly-hospital-initiative/the-ten-steps.  Accessed July 2014.

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As I look back on an almost 30 year career as a lactation consultant, I have witnessed a huge amount of change for the support of breastfeeding. It is heartening to see support from every corner; the federal, state and local governments, professional organizations, workplaces, and the Affordable Care Act. Even new mothers are better informed and more are choosing to breastfeed. But we still have a ways to go before we reach optimal breastfeeding nationwide.

There are pockets where breastfeeding rates are low and exclusive breastfeeding rates are even lower. Historically, areas that have the lowest rates are the US southeastern states. Also areas where African American, Hispanics and Native Americans live, rates are low.

Lactation Education Resources trains about 350 students to take the IBLCE certification exam each year. But we realize that often the areas that need it most do not have access to a certified lactation consultant. This year we have given four scholarships for our Enriched Lactation Consultant Training Program to individuals who indicated they intend to work in underserved areas once certified.

The winners of this year’s scholarships are:

  • Gloria Bauta, Miami, FL who will be providing low-cost lactation services to area mothers at MilkWorks

  • Jill Olds of Monroeville, PA who will be providing lactation services through her WIC clinic

  • Charlene Parrish of Whiteriver, AZ will be on the Fort Apache Indian Reservation, Whiteriver, AZ

  • Chanel Porchia of Brooklyn, NY will continue to offer infant feeding classes and free/low cost lactation services in her area.

Best wishes to these four winners who will be part of the next generation of Lactation Consultants.

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