Welcome to my IBCLC© Day 2023 Series! Each day I’ll share with you one piece of insight about our work. (If you’re too excited and you just want to read them all now, go here and download the whole list) Let me know in the comments if you agree, disagree, never thought about it this way, or whatever you’re feeling! 1. Even when you are an IBCLC, you won't know the answer to every question your client or patient asks. Really - you won't. They will have questions you could never have imagined. This goes for questions you will be asked by nurses, doctors, neighbors/strangers who found out you "do" lactation, and more. But here's the beauty: you will know how to find the answers they seek. There will be time to locate it. As you gain experience, you will begin to more easily navigate between those questions which actually have answers and those which do not ("there's really no research about this; that's why we base our practice on what we DO know and what makes sense biologically.") You have your textbooks and study materials, you know about great websites for credible, evidence-informed lactation information, and you're building your network of lactation colleagues so you can seek guidance and expertise. You are helping, even when it takes a bit more time to locate the answers your client is seeking. We don’t know everything we need to know right now, and science takes time because science is a process, not an endgame. Keep your mind open always to the wonder of human lactation and how it hits differently for every person. Keep asking questions. Keep learning (and not just from formal continuing education opportunities - learn from those you serve, read your journals, spend time discussing cases and concepts with your peers, including those in other health disciplines). Most of all, keep listening. We may hold expertise as IBCLCs, but there is always more we can learn. 2. The lactation plan you & your client or patient created might not be the one they decide to use. Circumstances change. People change their minds. Regardless of how much time you and your patient spent creating the "perfect" plan for them and their goals, by the next time you see them or speak to them, they may have moved on to a different plan. It's not a reflection of your worth as an IBCLC, nor is it an indication that your plan was not good. Your responsibility is to create the lactation management plan with your patient (and to document it). The patient is in charge of using the plan, and they can use it any way they want - as a strict guide to exactly what to do, as a list of suggestions, or as a way to understand what it will take to meet their goals and then make a decision about what they really want. When you learn that the plan is no longer in place, adjust your thinking, clarify what they need next, and be there for this next step. Show up for your client and their goals, even when they're shifting, and you can rest assured you are doing your job well. You cannot have an agenda in this work. You are not here to make people fit into a plan that feels right to you. You have to learn how to identify your personal biases about childbirth, lactation, and health in general; then you need to learn how to allow your professional responsibility to your client to override your personal biases. Supporting someone to meet their lactation and infant feeding goals is about building a relationship with them. It’s not easy for people to trust you, a stranger, when they are in the midst of experiencing the emotions and the whirlwind of life with their new baby. Remembering that can help you enter into each new dyad’s space with grace and respect. And keeping that perspective can help you navigate one of the more difficult - and sometimes surprising - realities of lactation care. 3. You won't "click" with every client. It's just not going to feel comfortable with everyone. You may get off to a rocky start in conversation, you may feel unqualified to help them for some reason, or you may even actually be acquainted with them in some other arena of life, leading to some bit of awkwardness. Build your relationships on respect and trust, and you'll find that people who may not seem to "like" you are actually quite glad to have your help. Show them that you are reliable and competent, and if there is a connection outside your lactation relationship, be very upfront with them about your commitment to confidentiality and protecting their private information. You are going to connect easily with many of the people you serve, and when you encounter clients who leave you feeling a bit challenged, always be honest with yourself and take time to consider why it feels strained. Lean on your network of lactation colleagues to help you understand these moments, and you'll find that everyone has these kinds of different relationships. What it looks like when you imagine a day in the life of a lactation consultant can be very different from the reality. You might envision feeling a real sense that you are making a difference every single day - changing lives, making people happy, squishing adorable babies. But the reality can feel very different. It’s important to know that going in so you can be prepared to remind yourself what you need to do to safeguard your own well-being in this career. 4. You may not feel like you accomplished very much at the end of a day of lactation work. There's no inbox and outbox in lactation work. Even if you work somewhere that provides you a list of patients to see on your shift or you start the day with your schedule of client appointments, results are not obvious and easy to see in this job. You may walk away from a day feeling as if you worked really hard and have no idea if you actually helped anyone. You may wonder if you are making a difference. Useful feedback can be hard to come by. Focus on this: your role - and the commitment you made as an IBCLC - is to show up for people who are seeking or who require lactation support and clinical expertise, and to provide that to them in a competent and compassionate way. Did you do that? You did. Even if you could never get that one baby to latch, and the mother you've been working with for 5 weeks is still struggling with milk production, and the parent on the phone is not seeming to accept the realities of the lactation plan you helped them create - you showed up for them and gave them the support they needed in that moment. It can be really hard to see how much your presence, support, and clinical assistance mean to people. It can be even harder if you work in a setting where your co-workers do not value your knowledge or what you do, or where they question your impact because they misunderstand breastfeeding in general. It is in these moments that you must widen your gaze - look up and out to the larger lactation field and seek the professional support you need from your network of colleagues. You are part of something much bigger, and it helps to remember that every day. 5. It may take time for your clinical lactation input to be accepted by the rest of the health care team - even if they knew you before as an expert with a different credential. It's true. Think of it this way: when you declared your intention to become an IBCLC, a slight separation emerged between you and the people you knew. You felt it. Some of them were incredibly supportive and respectful, while others put up a little wall (or a big wall). Why did this happen? It's the passion thing. They don't have it, and they might have some resentment and conflicts built up around it. They're putting that on you. YOU represent breastfeeding and lactation now, and some people are going to have a problem with that (which can feel like they have a problem with you). It can feel like you are being accused of “going to the other side.” Accepting this is something that is often unexpected when becoming an IBCLC. After all, we think lactation is fascinating and awesome, and it can be difficult to comprehend that others do not. It's ok - the world is made up of people who are fascinated with all kinds of different and amazing things. That's what makes life interesting! However, when there's a lack of respect, that's when it starts to impact your work. If you're included in multi-disciplinary rounds in the NICU, but your input is consistently dismissed or ignored outright, it may be time to gently inquire of leadership as to how you can best fulfill your role there. If the pediatricians are not referring patients to you as the in-house lactation consultant, you may need to address how your role has been presented to them. Essentially, these situations are usually opportunities to clarify your roles and responsibilities, and they are a great way to spread education about lactation. The most important point you can often make in these cases is a clear reminder that all health care workers have a responsibility to avoid their own personal biases about lactation when providing health care. On the surface, it seems like a passionate interest in human lactation and a deep commitment to learning and serving others would be all you need to become a truly wonderful lactation care provider. However, we are (like everyone else) human beings with complicated internal lives, and there’s more to it than that. 6. Your personal lactation experiences can have a positive or negative impact on your practice. Yes, you read that right. It's not just others in health care who can develop biases which impact their practice - we passionate supporters of lactation can have this problem, too! Here’s why: though you may have learned tons of information, accumulated hundreds of hours of clinical experience, and passed a rigorous examination for board certification, you may not have had the opportunity to debrief your own personal lactation and birth experiences in a way which highlights your potential problem areas. Biases can also
