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

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

  1. This is GREAT! I work really closely with lactation consultants as that is NOT my area of expertise as a doula and childbirth educator. I know the basics but I encourage any moms who experience difficulty to seek help from a lactation consultant right away. It makes such a huge difference!


  2. I just re-posted a link to this article on my facebook page (because I thought it was well worth reading). This is the response I got from a women who seems to either be an obgyn or work for one:

    “Insane—-the only thing a baby needs is its mother—no lactation consultants, food consultants, midwives, MOTHERHOOD comes easy love them feed them change them.”

    I was dumb-founded!! Is this the kind of respect/response you get from the medical community? Is this a typical attitude? No wonder the birthing/lactation experiences are so fraught with peril and difficult. Wow. (http://www.facebook.com/moboleez – if you want to respond back).


  3. Breastfeeding instruction (if any) received when baby / babies were born are mostly forgotten just days after baby / babies were born. Though many mothers figure out breastfeeding on their own, a visit with a lactation consultant may be a short-cut to more comfortable breastfeeding.

    My work as a doula is a short-cut to more comfortable parenthood and couplehood as parents. My role as a doula is to help the family experience competence. I dedicate myself to the new mother and her family; I help the new parents to find their own parenting styles and to negotiate their new role(s) as parent(s). I help new parents to become non-clinical experts on their baby or babies.

    And I’ve witnessed new mother clients benefit greatly not only from breastfeeding support by IBCLCs and others, but when I make other appropriate referrals; such as when I guide her and her partner to mothers or parents groups, personal organizers, food delivery service(s), postpartum exercise physiologists, babysitting help and other support specific to her and her family’s own unique needs. I see doulas and IBCLCs as partners in service to new parents; Doulas and IBCLCs are the most sympathetic, compassionate professionals you will ever meet; both help new parents tremendously, with differing areas of expertise, and bring more ease to life with baby or babies – a life that has been in the space of less than a year – made more busy and more full.


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