“If I’ve hired a doula, do I really need a lactation consultant?” Marsha Walker, RN, IBCLC

by Marsha Walker, RN, IBCLC | August 25, 2011 2:20 am

I was recently reminded of just how much I like doulas. As an International Board Certified Lactation Consultant (IBCLC), I was asked to speak at the 2011 Doulas of North America (DONA) conference in Boston. I had the pleasure of interacting with 300 doulas from all over the US, Canada, and Mexico. As the DONA website explains, “The word “doula” comes from the ancient Greek meaning “a woman who serves” and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.” Doulas and lactation consultants have a lot in common. Both doulas and LCs want to see their clients have success with breastfeeding…so how can they work together to do that?

Doulas are required to have a basic knowledge about breastfeeding so they can help mothers get off to a good start. Research has shown that the presence of a doula results in not only improved birth outcomes but also longer durations of breastfeeding, especially if a mother encounters a problem. However, employing a doula doesn’t necessarily eliminate the need for a lactation professional. I used to have a very large clinical practice, interacting with hundreds of breastfeeding families a year. I was always happy when I would receive a call from a doula who was helping a mother through some breastfeeding difficulties. The doula would come in to my office with the mother and baby and we would all work together to discover the problem and put in place a plan of care. I knew that the mother was in good hands and that the likelihood of resolving the problem was very high. These doulas knew that whatever the problem was, if it was beyond their scope of practice they needed to refer the mother to someone with the expertise to handle more complex issues. My talk at the doula conference was about what IBCLCs would like doulas to know. I talked about some of the more general observations to make regarding the baby and mother, along with some insight on basics and deviations from the norm. I discussed situations and conditions where doulas should refer their client to an IBCLC and where to find IBCLCs.

Even though you may have a compassionate and caring doula, sometimes breastfeeding can use more expert help. It’s at times like this that an IBCLC is needed to remedy the problem and preserve breastfeeding. We don’t hesitate to call the plumber when pipes spring a leak or take our car in when it starts making ominous noises. We visit a medical specialist when a problem goes beyond what our primary care physician is comfortable with. So too should we seek out an expert when breastfeeding runs into a challenge. There are so many more births today that are complicated by hospital interventions. More late preterm infants are born and develop feeding problems that need a professional who is qualified to handle the special challenges these early arrivals bring. We see more mothers with diseases and conditions that inject complexities into the breastfeeding experience. IBCLCs have become vital to preserve breastfeeding in these and so many other situations. It is important that mothers receive the level of care that they need. Always look for a lactation consultant with the IBCLC credential. This indicates a person with the appropriate knowledge and expertise that is most likely to successfully address whatever is challenging the breastfeeding couple. Your doula should know who the IBCLCs are in your area. You can also locate an IBCLC via the ILCA website.

Did you have both the care of a doula and help from an IBCLC?

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