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Early Breastfeeding Problems

The Hospital Where You Delivered
Many hospitals that serve mother-baby pairs have a lactation consultant or lactation nurse specialist on staff. The hospital also may have an electric breast pump that you can use on site to relieve severe breast engorgement. You can call the nursery any time night or day to discuss your problem with a staff nurse. Ask if you can talk with or be seen by the lactation consultant. Many hospitals offer follow-up services for new mothers and babies.

Lactation Consultants at Hospitals, Clinics, or in Private Practice
A lactation consultant (L.C.) is a relatively new member of the health care team who focuses on providing breastfeeding education to parents and on helping nursing mothers overcome breastfeeding problems. Many L.C.'s are registered nurses who have pursued additional training to work with breastfeeding mother-baby pairs. A lactation consultant can provide personal assistance with breastfeeding technique, teach you how to use a breast pump and other breastfeeding supplies, recommend ways to increase your milk supply, demonstrate alternative methods for feeding supplemen-tal milk when necessary, and offer essential support and educa-tion. Credentialing as an International Board Certified Lactation Consultant (I.B.C.L.C.) identifies individuals who have attained voluntary certification by the International Board of Lactation Consultant Examiners. To receive the I.B.C.L.C. credential, applicants must complete academic prerequisites and required practice hours assisting breastfeeding mothers, in addition to passing a comprehensive examination. The I.B.C.L.C. designation is the most widely accepted standard for lactation consultants, although some highly skilled breastfeeding specialists have not pursued this designation.

Your obstetrician, family physician, or pediatrician may work with one or more lactation consultants to whom you can be referred. You also can locate an L.C. in your community by contacting the International Lactation Consultant Association or Medela, Inc. (see Resource List, page 445). Nurses, midwives, dietitians, educators, and other individuals from a wide variety of disciplines work as lactation consultants. I recommend that you ask about the professional background and training of the person with whom you work. I cannot overemphasize the importance of good communication between your lactation consultant and your own and your baby's physicians.

La Leche League (LLL) International and Nursing Mothers Counsel
These volunteer organizations are excellent sources of information and mother-to-mother support for breastfeeding women. If these reputable groups are present in your community, they should be listed in the white pages of your phone book. Both groups provide telephone counseling, and La Leche League holds regular meetings. LLL also offers recorded information on selected breastfeeding topics and provides telephone assistance to health professionals and others, including mothers, through its Center for Breastfeeding Information. While knowledgeable counselors are present in both organizations, you should realize that these peer support groups are not a substitute for professional medical guidance.

The WIC Program (Special Supplemental Nutrition Program for Women, Infants, and Children)
Local WIC clinics provide helpful counseling for their breastfeeding clients, and many offer peer support. In addition, some WIC programs provide electric and manual breast pumps for mothers who need them. WIC clinics also can refer clients with complex breastfeeding problems to other community resources.

Lactation centers
Some breastfeeding mothers are fortunate enough to live in communities where a lactation center is available. These lactation programs often are sponsored by hospitals and may offer complimentary breastfeeding services for mothers who deliver there. In addition, they may provide outpatient consultation (for a fee) for mothers in their community who have breastfeeding difficulties. Most lactation centers also offer telephone advice, operate a pump-rental program, and sell breastfeeding supplies.

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From Dr. Mom's Guide to Breastfeeding by Marianne R. Neifert. Copyright © 1998 by Marianne R. Neifert. Used by arrangement with Plume, a member of Penguin Group (USA) Inc.

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