Breastfeeding Support: What is an IBCLC and How do I Find One?

I get messaged frequently with breastfeeding questions.  With the amount of research I did in the first year and the amount of questions I asked of Moms with much more experience than I, I have acquired a lot of knowledge about breastfeeding.  However, an experienced Mom does not replace the necessity and value of help from professionals.

Most Moms call or schedule an appointment with their pediatrician if they are having breastfeeding problems.  Or, at an appointment, the pediatrician will say, “your baby isn’t gaining enough weight,” and naturally Mom says, “what do I do to fix that?”

Unfortunately, pediatricians are not trained, educated, or specialized in breastfeeding as a part of their schooling to become a pediatrician.  Of course, there are exceptions to the rule…pediatricians who have gone above the “call of duty” and taken classes or become an LC or CLC.  But none of that compares to the extensive training and knowledge that an IBCLC has.  That is why whenever a Mom is having trouble, feeling like she’s not enough, or about to quit, I strongly urge them to see an IBCLC instead.

What is an IBCLC?

An IBCLC is an International Board Certified Lactation Consultant.  They are by far the true experts in breastfeeding.  There are currently 28, 105 IBCLC’s around the world, 15,144 of those in the United States alone.  “Certification is recognition that an individual has met eligibility requirements and has passed a rigorous exam that assesses knowledge in breastfeeding management.” (Source)  I have a friend who is at this moment a couple days away from her exam.  She has been studying regularly and taking practice exams for it for many months even though she has been involved in breastfeeding education for years.

What does an IBCLC do differently from a Pediatrician?

An IBCLC is trained to be able to accurately determine the source of your problems and struggles with breastfeeding your child.  There are some really cool things they know how to do that are all evidence based care.  They know how to determine exactly how much baby is getting in a feed, how to assess for suck strength and coordination, how to listen to hear how much milk is being transferred on sucks, how to assess for lip and tongue ties accurately (it’s much more than a glance in their mouth), how to troubleshoot babies who have a hard time latching, how to truly determine a low supply issue, how to help Moms keep their babies on breastmilk even if Mom truly does have a supply issue, and so much more.

It took a ton of demanding and a hospital transfer to get an IBCLC in the NICU with my babies and I.  The experience with the LC at the first hospital compared to the IBCLC in the second hospital was an immediate and obvious sign of the difference in education for me.  The LC at the hospital came into my room with no babies in it, asked me what problems I was having, and without accompanying me to the NICU to troubleshoot those problems handed me one (not two) breast shields and said, “here, use this.  But I wouldn’t get your hopes up.  They’re in the NICU and you probably won’t make it breastfeeding.”  And left.

When we transferred to a new hospital, I demanded to immediately see an IBCLC.  The IBCLC was basically waiting in the girls isolation room when we arrived.  Within 10 minutes she had me successfully tandem nursing BOTH babies.  Granted, we did end up using those shields because of flat/semi inverted nipples combined with lip/tongue ties…but they were latched…for the first time in their lives….with just 10 minutes of help from an IBCLC.

The next IBCLC I saw was actually a part of the WIC program.  Not every WIC program office has an IBCLC on staff.  But I specifically drove to that office to see her because I needed the expert guidance.  She assessed both girls for ties, watched me latch and feed the girls with the shield, watched me attempt to latch without the shield, helped me with positioning, encouraged me that I was doing a great job, wrote a recommendation that the girls be assessed for ties by a pediatric ENT, did weighted feeds to get an idea of how much the girls were taking in each feed, and gave me hope that one day it wouldn’t be so hard.

We saw her one additional time for another weighted feed (I believe after the ties were cut but I’m not positive…everything is so foggy back then) and to meet my husband and have him ask questions on how to support me with breastfeeding.  She also reassessed latch and positioning.

The only thing my pediatrician did for breastfeeding was argue with me that the girls didn’t have lip or tongue ties (they did), roll her eyes when I said I wanted to feed them both exclusively at the breast, and reprimand me for not knowing exactly how many nursing sessions they had or how many diapers they had (plenty and plenty).  The doctors at the NICU were the same and actually fed formula even though I specifically told them they weren’t allowed to because they believed formula was superior to breastmilk.

How do I find an IBCLC?

KellyMom does a great job at giving a wide variety of resources in this article.  My favorite is this search directory.  All you have to do is put in the state you’re in and it will pull up all of the IBCLC’s in the state!  This is a great tool if there are no IBCLC’s that work in your local WIC office or hospital.

 

At the end of the day, an IBCLC is a vital part of a healthy and successful nursing relationship.  Even at nearly two years postpartum, if I were to have a proper latch issue because of new teeth, injury, or something like that, I would absolutely seek out the help of an IBCLC first and foremost.

Have you ever worked with an IBCLC?  What was your experience?  Share with me in the comments!

Diamond Boobies! A Brief Summary of 18 Months Breastfeeding Twins and My 5 Keys to Success

When I first started seeking other twin Moms for advice on breastfeeding, I kept getting variations of the same advice.  “The first 6 months are pure and complete primal survival, the first 12 months are really difficult, and the first 18 months are just difficult.”  It would get easier, they said, in those increments, but the first 18 months were by far suggested to be the most difficult timeframe for nursing twins.

Boy were they right.

12509316_10154625373978475_8787246130014027012_nNow that I’m on the other side of the dreaded “first 18 months”, I have wisdom to share.  Lots of it, as a matter of fact.  I claim to be no expert…insist I am the know-it-all of nothing…but I lived through these 18 months as a first time Mom with some very very difficult obstacles and here we are.  So, I hope what I learned helps at least one twin Mom struggling to find her way.

First…a brief summary of the struggles we faced.  Some of these struggles are unique to my situation but many are not only common among twins but common among breastfeeding Moms in general!  I’ll make this in a list for ease of reading.

  1. My twins were born preemies at 36+1 by crash C-section and required heroic measures to come Earthside.
  2. I did not meet River until she was over 30 hours old.
  3. I was ignored and not provided a pump until nearly 12 hours postpartum despite asking hourly.
  4. I was denied a lactation consultant until more than 50 hours postpartum AFTER Serenity had also been stolen from me and admitted to the NICU, despite demanding one over a dozen times.
  5. The “lactation consultant” (I put that in quotes because she doesn’t deserve that name) did nothing to actually help me succeed in breastfeeding.  She handed me a nipple shield (a shield…not two) and shrugged and said, “Well, your babies are in the NICU so you won’t get to breastfeed anyways.”
  6. I was not encouraged to visit my babies and was shooed out of the NICU.
  7. I was discouraged from touching, getting close to, or holding my children.
  8. I was not taught how to pump or given syringes to suck up the drops of precious colostrum until 3 days postpartum.
  9. My colostrum was never fed to my preemies until we switched hospitals despite my demanding it be done.
  10. Both of my twins had lip and tongue ties.  My doctor denied the existence and it took a wonderful IBCLC, demanding my pediatrician for a referral, and a visit to a pediatric ENT to get the diagnosis and revision.  This didn’t happen until they were 8 weeks old.  That’s over 675 feedings for two babies (so over 1,300 nursing sessions) that I had to hobble my way through with extreme pain and reflux and struggle latching.
  11. My children’s first latch did not happen until they were nearly 4 days old.  It was only possible through the help of a skilled IBCLC, a nipple shield, and determination.
  12. I was severely depressed and pumped maybe 5 times a day during their NICU stay.  I didn’t pump overnight.  This is NOT ok.
  13. The NICU overfed, didn’t pace feed, forced formula against my consent, gave pacifiers against my consent, and many other anti-breastfeeding actions.
  14. I was sent home from the NICU with a massive amount of formula “for when I gave up.”

I think I’m going to leave it at that for my list.  There is more but I’m exhausted just writing that much.  Needless to say, our journey was difficult.  We hit so many bumps in the road.  I felt like I was running around like a chicken with my head cut off.  I felt like days molded into nights and into weeks and months.  Days and nights were exhaustingly long but weeks flew by and I felt I had accomplished nothing.  My entire existence was nursing, pumping, and changing diapers.

But, that crazy beginning didn’t last forever.  Slowly, as we muddled our way through each bump, things started to get easier.  I became more and more comfortable with nursing.  I got better and better at nursing in public.  Growth spurts didn’t completely unravel me anymore.   I didn’t feel blind sided by their cues anymore and started anticipating their hunger and catching early signs of hunger.  It got easier.  And easier.  And after the 6 month growth spurt, it wasn’t impossibly hard anymore.  And after the 12 month growth spurt…and a minor meltdown by my wonderful self…it wasn’t extremely difficult anymore.

Now that we are on the other side of 18 months, I have found that nursing is almost always enjoyable and easy.  It is a cure all.  It fixes all bumps and bruises.  It fixes hurt feelings and sadness.  It fixes over tired toddlers and helps settle big emotions.  For me, it helps me slow down and reconnect.  It helps me remember not to get so tied up in housework.  It helps me remember to kiss and hug and smell and snuggle my kids and gives them the stillness for me to do so.

Nursing is incredibly versatile and a huge part of my key to raising twins overall.  So, here are some of my biggest tips on how to get through those impossible stages to make it to the wonderful stages…

 

  • Don’t assume it will be hard or that you will struggle.

Not everyone with twins has NICU time.  Not everyone with twins has a traumatic birth.  I know some incredible Moms of multiples who had unassisted home births with twins or home births with a midwife.  I know Moms who had planned C-sections that were absolutely beautiful too.  They had that beautiful first latch, the immediate skin to skin time, the perfect synchronization from the very beginning.  I know Moms whose babies never struggled with reflux, never fought a latch, never needed a shield.  It is not a guarantee that you will struggle and have to fight this uphill battle to breastfeed.  Do not ASSUME that you will hit every obstacle because it will make you pessimistic and less likely to persevere through growth spurts and sleep regressions.

  • Build your breastfeeding support networks while you are pregnant.

The ONLY reason why I did not give up is because of support.  I cannot stress enough how incredibly and vitally important having support is.  I don’t believe that I would have struggled as much as I did if I had set up my support networks for breastfeeding BEFORE birth.

Find a La Leche League or breastfeeding sisterhood in your area while you are pregnant and start going to meetings WHILE YOU ARE PREGNANT.  Make sure that you get to know the IBCLC running the group.  If there is not an IBCLC running the group, get recommendations for an IBCLC and talk to them.  Anticipate using their services and do not be afraid to call them.

Join Facebook groups that use evidence based advice and are not quick to supplement.  The Facebook group “Breast Friends” is by far one of my favorite groups of all time.  They use completely evidence based practices, do not recommend formula supplementation unless every single other option has been exhausted and there is a true need, help assess situations and find Mom proper support, and don’t take bullshit when it comes to bad advice.  I also love the group “Nursing Twins”, which is a multiple’s specific group and abides by the same high standards that Breast Friends does when it comes to supplementation, formula use, and bad advice from pediatricians (which is so common it blows my mind).  In my early days, another group that was very helpful was “Mothers Nursing Multiples” and a local group to me at the time that was connected to the sisterhood I attended.

  • Say “yes” to every single person who offers support after you give birth.

Do not be a hero.  I repeat.  Do not be a hero.  SAY YES.

“Can I bring you a meal?” YES

“Can I clean up your kitchen for you?” YES

“Can I throw some laundry in for you?” YES

“Would you like me to watch the babies while they sleep so you can go take a shower?”  YES YES YES

I did not say yes nearly as much as I should have.  Please for the love of everything that is milky, say YES.  Accept any and all love you are offered.  Know what is helpful and what is not.  Offers to hold babies while you do chores is not helpful.  You need to be close and connected with your babies in the early days so that you can master breastfeeding.  Offers to do housework, make food, walk your dogs, let you shower or do other self care tasks, watch a show with you while you nurse to keep you company, all are very helpful.

Motherhood is not this lonely solitary journey that society has made it out to be in recent decades.  It is successful when our significant other is supportive, patient, kind, and helpful.  It is successful when the people we surround ourselves with are just as much that too.  It takes a village.

  • Understand that if it hurts, something is wrong, and seek help immediately.
10624556_10153416468883475_7024103770513714895_n

Serenity’s lip tie before revision

Breastfeeding DOES NOT HURT.  In the very early days when your nipples are becoming accustomed to the stimulation it may feel uncomfortable for the first 30 seconds or so.  But, I spent 8 long weeks in literal tears during every single feed because it was so painful (remember that’s over 1,300 feeds for twins).  The nipple shield caused deep fissure cracks in my breasts because I was not using it correctly because of lack of knowledge and help.  An undiagnosed lip and tongue tie was the main cause for our pain and had it been corrected in their early days of life I would not have struggled.  So, seek help.  Visit that IBCLC.  Ask questions at your sisterhood or La Leche League groups.  Ask questions of your friends who have succeeded in breastfeeding.  Demand a consultation with a pediatric dentist or a pediatric ENT (the ONLY doctors who are qualified to diagnose a lip and tongue tie).  Do not take no or “it’s normal” or “just switch to formula” for an answer because pain during breastfeeding is not normal.

 

  • Trust your body

Finally, and probably the most incredibly important tip I have, is to trust your body.  Only 3% of Moms have a legitimate and true issue with supply.  THREE PERCENT.  Yet, on many mainstream Mom groups I see dozens upon dozens of Moms say they “couldn’t” breastfeed because of “low supply”.  Beware of the top up trap.  Beware of comments and advice that is not breastfeeding friendly.  Beware of doctors that want preemies to “catch up” and gain weight according to a formula feeding chart by chronological age.  Beware of anyone telling you to feed on a schedule.  Beware of anyone telling you that you can’t possibly be enough.

You are enough.  Your body just spent the better part of a year growing TWO human beings from just two cells.  At the same damn time.  Your body is incredible.  TRUST your body to continue providing for those tiny humans just as you trusted your body to provide for them while you were pregnant.  Count diapers and know how many are ok (6+ in 24 hours for a baby over 5 days old).  Know what breastfeeding weight gain is normal (3-7 ounces a week).  Understand that your baby cluster feeding, feeding often, feeding for a long time, or fussing or being cranky are NOT signs that you have low supply.  Not feeling engorged is not a sign of low supply.  Your baby guzzling a formula bottle is NOT an indicator of low supply.

TRUST YOUR BODY.  Breathe, breastfeed, eat, sleep, and heal.  Those are your only jobs in these early days.  You are enough.

Twin newborns is no task for the weak.  But, with these tips and hard work, maybe you can avoid some of the struggles that I had while breastfeeding twins in the early days.

For Moms with older twins who breastfed, what were your keys to success?  What helped you get through those early days?  Share your story of full term nursing in the comments below!

 

Note:  If you would like to be added to the “Breast Friends”, “Nursing Twins”, or “Mothers Nursing Multiples” facebook groups, please e-mail me at doublecrunchblog@gmail.com.  They are secret groups so cannot be linked.  I would be happy to help you into the groups if you need the support.