Beyond Lactation Clients:
Who We Teach
Show Notes at christinestaricka.com/blog/episode16
Hi and welcome to the Lactation Training Lab Podcast! I’m Christine, an IBCLC and lactation career coach. I help current and aspiring lactation care providers optimize their lactation practice and career through resources, information, and mindset shifts that help them to clarify and re-claim their purpose and mission in lactation work. I’ve been in the lactation field for 20 years now and this podcast is my way of sharing with you what I’ve learned and what the future holds for those of us supporting families and babies. Whether you’re seasoned or studying, I hope this show will make you think and inspire you to act. Let’s get started.
This is the origin story of the First 100 Hours - a client receiving ultimatums about providing milk for her preterm twins, having her own personal medical condition overlooked as a source of lactation problems, misunderstanding on the part of a doctor - the focus was on pump with no hand expression, wrong expectations for onset of Lactogenesis II, volume of milk, progression of lactation - but the client was not the one with the education gap! She knew the facts, and she knew what to do. She had agency and spoke up and asked for what she needed. It was the rest of the health care team struggling to provide her with the right information and the support she needed in that moment. So imagine what was happening to people who didn’t have the agency to speak up and ask for what they needed - their ability to breastfeed and to produce milk for their babies was being compromised and they were experiencing harm.
I realized that I was frustrated, but not with the client. I was frustrated with the hospital staff, with the cultural messaging surrounding her, with the environment of commercial and marketing influence on pregnant people and new parents. Most of all, I was frustrated that I didn’t know how to effectively communicate what I knew about how lactation works to anyone other than my client and her partner.
I felt like I should have had better skills, better preparation for this moment. I felt like after all the years I had spent working in that place with those people, I should have been able to make a bigger difference and influence more people.
I felt like I had to create a plan and a way to focus on how exactly to explain what is supposed to be happening in terms of lactation in the first few days of a baby’s life, and I did. I knew it needed to be as simple as possible because that would be practical for tired new parents, but also because despite their complex medical training - or maybe because of it - the hospital staff and healthcare team just didn’t get it. They frequently over-complicated it, relied entirely on equipment and tools, or simply passed on misinformation OR their personal biases about lactation to patients in a way that I felt would not be happening in any other area of health care.
In the years since I first wrote and implemented that plan, I have also seen an alarming increase in reliance on breastfeeding tools and devices when no indication is present for their use. The alarming part is how much the decision to use tools and devices is being influenced by health care workers and people in the community who are not trained in lactation care, The casual way these devices and equipment are often discussed leads new parents into thinking that they need them in order to breastfeed or make milk, and that simply isn’t always true.
The antidote to health care workers relying on and encouraging reliance on equipment and tools is INFORMATION and training on how human lactation works. Education is always the answer. But we could sit around for another 3 decades shuffling uphill, trying to get medical and nursing school curricula to include lactation training, or we can bring understanding in the healthcare setting. We can impart knowledge to the people we actually work with in real life using cases sitting before them. We can offer guidance and wisdom with sensitivity and respect for our health care colleagues’ experience and expertise.
When I think back to that origin story - to that one mother and her partner and their frustration and stress - I think about how things could have been so different for her if the health care team had better knowledge about how lactation works. If they had realistic expectations for how much milk this mother could expect to see at 36 hours postpartum. If they had understood that sometimes we have to consider that equipment like breast pumps are not the right answer in those first days. If they had been guided by the underlying concept that breastfeeding is a normal physiological function. If they had used their broader medical knowledge to consider that a concurrent medical condition might be impacting lactation in that moment. If they had acted on the science surrounding the impacts to the preterm infant microbiome when infant formula is introduced first, instead of an attitude that formula is all about feeding choices and is basically the same as human milk.
This is how we make that bigger impact we all want to have: we never rest. We never stop making ourselves better at what we do, reflecting on what we’ve learned, serving parents one-to-one with the highest quality lactation care and serving the health care community as their personal guide into the importance of human lactation. We look up and out to the horizon, and we find the places and the people with whom we can open lines of communication and influence, and we confidently step up when those opportunities come.
Thanks for joining me here on the podcast. If you like what you hear, please join the conversation in the free Lactation Training Lab FB group. I’ll link to it in the show notes and look for you there! Talk to you again soon!