Should you see a lactation consultant?

Most healthcare professionals receive some training in breastfeeding during their initial pre-graduate studies. For doctors this training is very basic, consisting of only a few lectures. Nursing sisters and dieticians will get more information as they work with breastfeeding mothers more directly. And of course those who end up choosing a career path like paediatrics or well-baby care will learn more about breastfeeding at conferences and in-service trainings. They will also build experience as they carry on, plus may or may not choose to breastfeed their own babies.

And for a mom and baby who is breastfeeding well and without any difficulty this assistance may well be sufficient.

But if there are more complicated breastfeeding issues, many of these professionals feel that they are not equipped to deal with them. And most women who stop breastfeeding in the early weeks would have been able to continue if they only received the right information and support.

Apart from this, moms who struggle also need ongoing support, and someone to give the guidance and monitor their progress once they are discharged to go home.

This is where a lactation consultant comes in.

What is a lactation consultant?

In short, this is a professional that specialises in breastfeeding. In South Africa you will encounter two types of lactation consultants.

An IBCLC, or International Board Certified Lactation Consultant completed studies regulated by an international board across all countries. This is the preferred course for professionals wanting to work in other countries, as it is internationally recognised. In South Africa, for many years only a very small handful of IBCLC’s were available for breastfeeding moms.

A SACLC (South African Certified Lactation Consultant) completed a postgraduate course through WITS University. This course was developed specifically for healthcare professionals like Registered Nurses, dieticians, medical doctors and speech therapists working in South Africa. The SACLC course is more affordable and accessible, and ideal for healthcare workers planning to work only in South Africa. Thanks to a local course there are now many more lactation consultants in areas where previously a mom would have been on her own.

Once you understand that it takes a few years to complete either of the above courses, with in-depth study and many practical hours, you will understand that you cannot expect the same level of care and knowledge from someone who completed basic training. 

A lactation consultant will spend a minimum of 1,5-2 hours with a mom (often more) and will provide follow-up care and support. With staff shortages in hospitals there is no way that the nursing sisters can do this for every mom, nor can your paediatrician during your standard visit.

When should you see a lactation consultant?

If you struggled with breastfeeding with a previous child, or if you have specific concerns before the birth of your baby it may be worthwhile to see someone in your pregnancy already to gather information and to make sure that you start off on the right foot.

Once you start breastfeeding, any of the below difficulties may be an indication that you need help:

• A baby refusing to latch beyond the first day or two.
• Nipple pain, especially if you experience pain throughout the feed, or if the pain is severe and your nipples are cracked and bleeding.
• Breast engorgement, especially if it lasts longer than 2 days, or if it is so severe that your baby cannot latch, or if your breasts doesn’t feel emptier after a feed.
• Any signs of mastitis (flu symptoms, fever, red area on the breast, breast feeling warm)
• If you are worried that your baby is not getting enough milk or that your milk supply is insufficient.
• If at any stage along your journey there are concerns over baby’s growth and weight gain
• If your baby is generally sleepy and feeding for only short periods – read more about how often your baby should feed
• Anything else that doesn’t feel right, or that you are not sure off

Do not delay getting help

Any beastfeeding difficulties in the early weeks have the potential to cause long-term problems if they are not addressed and resolved. The sooner you get help, the better. Rather see someone unnecessarily than to later sit with problems that could have been prevented.

But what about the cost?

The cost of an initial visit with a lactation consultant will pale in comparison to the cost of formula feeding baby in the longer run.

Most medical aids will pay in the region of R500 for a lactation visit. A lactation consultant may change a bit more depending on the circumstances (for example if she visited you at home and had to travel), and depending on the length of her visit and any other care given. Considering the amount of time they spend with moms, and comparing this to the what you pay for any other healthcare visit, seeing a lactation consultant is actually not expensive.

Do still make contact, even if you cannot afford a visit. She may be able to refer you to a student who still needs practical hours, or she may know of support groups in your area where you can also get assistance.

During the COVID-19 pandemic many consultants started doing virtual consultations as well, meaning that you can see someone no matter where you stay.

So where do I find someone?

Email us on info@allthingsbreastfeeding.co.za for assistance in finding a lactation consultant in your area.