Why Your Nurses Don’t Need to Be Responsible for Lactation Support

By Ali Weatherford in consultation with Andrea Carrasco, RN, ICCE

Most people don’t know what to expect when they’re in the hospital after giving birth for the first time. You might expect to be cared for by nurses, but there’s more. There may be many types of nurses you’ll see throughout your experience, each with a special set of skills. You’ll also be visited by other care providers. In many cases, one of these will be a lactation consultant (IBCLC). 

Why You Want an IBCLC

An IBCLC is a lactation consultant certified by an international board. The education and training requirements to be able to even sit for the board exam are extensive, and the exam is very rigorous and only offered twice a year. Before taking the exam, a person will have completed the following requirements: 

• IBCLCs must complete credits for an Associates degree in health sciences, taking a total of 14 courses.
  • Core courses: 8 college level, semester-based courses from an accredited institution of higher learning.
    • Biology
    • Human Anatomy
    • Human Physiology
    • Infant Child Growth and Development
    • Introduction to Clinical Research
    • Nutrition
    • Psychology or Counseling Skills or Communication Skills
    • Sociology or Cultural Sensitivity or Cultural Anthropology

• Continuing education courses: 6 college level, semester-based courses offered by an accredited institution of higher learning or independent continuing education (CE, CEU) provider. Check with your local community college for availability of continuing education courses.
  • Basic Life Support
  • Medical Documentation
  • Medical Terminology
  • Occupational Safety and Security for Health Professionals
  • Professional Ethics for Health Professionals
  • Universal Safety Precautions and Infection Control

• Lactation consultant candidates must also complete 95 lactation-specific continuing education units (CEUs). Unlike college courses, these are hour-for-hour credits
• The candidate must then complete either 300, 500, or 1,000 clinical practice hours, depending on the pathway chosen and previous training, work experience, or certifications. For example, someone with an RN license would need fewer clinical practice hours to complete the training. 

You can see that earning this certification requires a lot of education and training, and is very lactation specific. They are specialists, and they are your best resource for any information, education, assessments, and treatment plans related to lactation. 

Who You See in the Hospital

Very often, parents are confused about who is visiting with them in the hospital. During birth and in the couple of hours following, your care team will be mostly labor and delivery nurses, and some time with a doctor and/or midwife. Sometimes, a lactation consultant will be there in labor and delivery right after your baby is born. After that, most hospitals will transfer you to another room in another unit for the rest of your hospital stay. There, you’ll mostly be attended by postpartum or “mother/baby” nurses and technicians, and you’ll receive some care from doctors and/or midwives. That is when you’ll most likely see a lactation consultant. 

Your labor and delivery nurses have very specialized training, skills, and a passion for that work. Your postpartum nursing team has a different set of very specialized training, skills, and a passion for that kind of work. Your lactation care provider has a different and special set of training and skills. And they usually do the work because they have a very particular passion for it as well. I think you are fortunate to have such specialized teams looking out for you and your baby. However, it’s important to know to ask about particular issues you might be having. 

Nurses and Lactation Care

Most nurses in labor and delivery and in postpartum care do not have a lot of lactation specific training. They usually get a few hours, or a day, of training related to lactation when they start, and then they may do some continuing education or refreshers along the way. This training is often focused on how to get started with breastfeeding when things are going normally. You saw in the first part of this article that an IBCLC gets significantly more training related to lactation. That is what makes them specialists. Some nurses do choose to spend more of their time learning about lactation, but in general, they are there to help you with the basics. 

But it’s good to remember that it’s not the main focus of their work. They have a list of important things to do that have to be prioritized. They will help with lactation whenever they can, but it may not be at the top of the list. So, please remember that: 

1. Your nurses may not have the expertise needed to handle all lactation related issues and be able to create a treatment plan for you so you can breastfeed successfully. And they may not feel very confident to help you with anything but very basic breastfeeding. 
2. Your nurses are very focused on other aspects of your and your baby’s medical care. Your lactation consultant is ONLY focused on your feeding goals and needs. 

What All of This Means For You

When you’re in the hospital giving birth and recovering from giving birth, breastfeeding can come as a shock. It can be hard to shift from pregnancy mode-to birth mode-to breastfeeding/parenting mode. You might feel overwhelmed and even a little shell-shocked. You might not know what to do to feed your baby, and you might not feel prepared for the fact that you might need some help with it. We understand this, and that’s why lactation-specific support is provided by so many hospitals. Here are some things you can do: 

1. Accept any and all visits from your lactation care provider. 
2. Have a partner or other support person in the room with you during any visits. Ask them to take notes for you. It can be hard to take in all the information in the moment. 
3. Ask for help from the IBCLC any time you’re struggling. 
4. If your lactation consultant develops a treatment plan for you, be sure to let your nursing team know, and continue to follow it unless otherwise directed by your IBCLC. 

Your nursing team is the most available resource while you’re in the hospital. They are dedicated to your care and your baby’s care, and they want to help whenever they can. They are specialistsso many things. However, your IBCLC should be your go-to for all things lactation. That’s what they are there to do. It can be confusing to hear conflicting advice from different members of your care team. My best advice is to go to the ultimate source for the specific help that you need first, and then follow their guidance.