There are times when you may need to contact and International Board Certified Lactation Consultant (IBCLC) and other times when your La Leche League Leader, Doula, Certified Lactation Counselor, etc. may be the right person for the job.  So when SHOULD you contact an IBCLC?

Prenatally
When you have concerns about breastfeeding due to:

• Breast Surgeries such as reductions, implants or biopsies.
• Health concerns such as Polycystic Ovary Syndrome, Diabetes, Thyroid issues, etc.
  
• Previous unsuccessful breastfeeding experience.
  
• When you are adopting a baby and hope to breastfeed the adoptive baby.
  

Postpartum

• When you are experiencing PAIN while nursing.  Some discomfort is to be expected.  We describe the discomfort as being at the level of a mild sunburn (perhaps a four on a scale of one to 10, with 10 being high pain).  Beyond that you should call for help.
• When your nipples are cracked and/or bleeding.  OUCH!!  
  
• When you are concerned about baby's weight gain.
  
• When your doctor is concerned about baby's weight gain and is suggesting formula supplementation.  
  
• Any breastfeeding questions that are beyond the scope of your other care providers.
  

To find an IBCLC in your area you can search the International Lactation Consultant Association website here.
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What is the role of your Doula in supporting your breastfeeding relationship?  

I was reading a Facebook post recently about a mother's first birth/breastfeeding experience.  She made a comment similar to, "I did everything right.  I hired a doula, had a natural unmedicated birth, etc. and still had breastfeeding issues."  I thought to myself...what do mothers expect from their doulas in regards to breastfeeding support? 

Doulas are Childbirth Professionals which doesn't actually mean that they are Breastfeeding Professionals.  In San Antonio I am currently the only Doula that is also an International Board Certified Lactation Consultant (IBCLC).  Many of my fellow Doulas have made the effort to obtain additional breastfeeding education which is something I applaud them for and support them in doing.  I love being a resource for my fellow Doulas who come to me asking which programs I recommend or ask for guidance on their road to becoming more breastfeeding proficient.  

Two weekends ago my business partner Ginger and I taught a class to a group of newly trained Doulas on Breastfeeding.  We loved working with these new Doulas and we loved putting together the class.  Here is some of what we shared with those Doulas regarding the Role of the Doula in regards to Breastfeeding:

At your prenatal visits your Doula should...

• Discuss breastfeeding basics, skin-to-skin and how your birth can affect your breastfeeding relationship.
  
• Provide you with resources for local breastfeeding classes and support groups.
  
• Suggest breastfeeding books, dvds, etc. that would be helpful to you.
  
• Discuss your plans to go back to work and how that will affect breastfeeding.
  

At your birth your Doula should....

• Assist you with latching your baby.
  
• Make you comfortable and take care of any needs that you have while you are nursing.
  
• Ask the medical staff for assistance if you need it and she is unable to provide it.
  

At your postpartum visits your Doula should....

• Make sure that breastfeeding is going well.
  
• Make sure that you are taking care of yourself so that you can take good care of your baby.  Hydration, nutrition and rest are important to successful breastfeeding.
  
• Provide resources for lactation professionals if you need additional support outside of her knowledge.
  

What your Doula should NOT do....

• Provide assistance out of their Scope of Practice.  For example,  a Doula should not be doing an oral assessment on a baby unless she is a trained lactation professional and is working under that scope.
  
• Your Doula should not be in the way during your initial breastfeeding and should make sure that your partner is able to see what baby is doing so that they can assist you when no one else is around.  
  
• Your Doula should not be holding your baby for long periods of time.  Your baby needs to bond with you and your Partner.  Your baby should be learning your scents and tastes not anyone else's.  The Doula should never be center stage at a birth especially during early bonding.
  

Make sure that your Doula is covering the topics that we suggested and that they are not working outside of their Scope of Practice.  Working with babies is a delicate thing.  A newborn baby can start to go downhill pretty quickly if they are having issues with milk transfer or if you are having issues with your milk supply.  You should always consult with your Health Care Provider as well as with an IBCLC when you are experiencing breastfeeding difficulties.