Action Step 11: Access to IBCLC's

Photo courtesy of the IBLCE website.

This is our final blog in our World Breastfeeding Month series of articles. Today's action step is so important for nursing mothers. Although community support groups like La Leche League offer an incredible opportunity for mothers to get breastfeeding help, sometimes an IBCLC is really the key to helping a mom overcome a breastfeeding problem.
This information comes from page 48 of the Surgeon General's Call to Action to Support Breastfeeding.



Action 11. Ensure access to services provided by International Board Certified Lactation Consultants.

International Board Certiied Lactation Consultants (IBCLCs) are the only health care professionals certified in lactation care. They have specific clinical expertise and training in the clinical management of complex problems with lactation. Better access to the care provided by IBCLCs can be achieved by accepting them as core members of the health care team and creating opportunities to prepare and train more IBCLCs from racial and ethnic minority groups that are currently not well represented in this profession.

Implementation Strategies 

Include support for lactation as an essential medical service for pregnant women, breastfeeding mothers, and children. Third party payers typically define a standard package of health benefits for women and children. Including standard coverage for IBCLC's as “covered providers” when they perform services within the scope of their certification would ensure that mothers and children have access to these services through insurance maternity benefits. Federally funded health benefit programs, such as Medicaid, the Children’s Health Insurance Programs, Tricare, and the Federal Employee Health Benefit program, could serve as models for such a standard benefit package.

Provide reimbursement for IBCLC's independent of their having other professional certification or licensure. The taxonomy for health care clinicians defines qualifications of clinicians to be reimbursed. One option for reimbursement would be to place certified lactation consultants within the category of “nursing service related providers,” and specifying the nature of care they provide would allow for reimbursement of IBCLC's without requiring that they are also registered nurses. Alternatively, developing state licensure of lactation consultants could help to achieve the same purpose.

Work to increase the number of racial and ethnic minority IBCLCs to better mirror the U.S. population. Racial and ethnic minority communities tend to be underserved by lactation consultants. More students from these communities could be trained in human lactation to increase careers in lactation consultation. Area Health Education Centers could be encouraged to establish community-based training sites in lactation services.

Getting Involved

A Nurturing Moment is actively involved in a program to provide IBCLC's for area doctor's offices. Many pediatric and obstetric practices around the country routinely employ the services of IBCLC's for their patients, and it is our hope that this trend will extend to the Tennessee Valley. One of our long-term goals with our non-profit, The MOM Foundation, is to mentor minority women who would aspire to a career in lactation. At present, however, we are more focused on developing peer counselors in economically disadvantaged areas who will be able to encourage breastfeeding in their own neighborhoods.

Because we have two IBCLC's on staff, we are usually able to see mothers the same day they call for help. We deeply appreciate the many doctors who routinely refer patients to us, and are thankful that they view us as part of the health-care team. We are careful to keep communication open with the referring physician because we recognize the team nature of our efforts to serve moms and babies.

Action Step 8: Continuity of Care

This is the third in our series of articles based on the the Surgeon General's Call to Action to Support Breastfeeding. The U.S. Breastfeeding Committee has suggested a specific focus for each day of August. Today we're actually looking at the focus from Wednesday.  The text below comes from Pages 45-46 of the Surgeon General's document.

Action 8. Develop systems to guarantee continuity of skilled support for lactation between hospitals and health care settings in the community. 

Image from Wikipedia

Upon discharge from their stay in the hospital, many mothers are unable to find and receive skilled breastfeeding support. Mothers often are left on their own to identify resources to help with questions and problems they may have with breastfeeding. Furthermore, hospitals, clinicians in the community, and community organizations typically lack systems to help connect mothers to skilled persons who can offer support for breastfeeding. Ideally, there would be a system to ensure that breastfeeding mothers and their infants would receive skilled support with lactation from informed and available health care teams. Hospitals, primary care clinicians, and community organizations share responsibility for creating such systems.

Implementation Strategies 
Create comprehensive statewide networks for home- or clinic-based follow-up care to be provided to every newborn in the state. Follow-up support for breastfeeding needs to be integrated into home visitation and postpartum care programs. Staff training in breastfeeding management would be fundamental to this care.

Establish partnerships for integrated and continuous follow-up care after discharge from the hospital. Communities often provide a variety of resources to help breastfeeding mothers, including peer support networks, breastfeeding clinics, lactation consultants, and support groups. Health care systems can ensure that their patients are informed about such resources and can facilitate connections to these resources. They can also help to strengthen or create these programs.

Establish and implement policies and programs to ensure that participants in WIC have services in place before discharge from the hospital. Community partners and key stakeholders, such as hospitals, lactation consultants, and other clinicians, can work with WIC to establish continuity of care for WIC participants who breastfeed their infants. In addition, WIC state agencies can collaborate with state hospital associations to identify key barriers to the provision of WIC services within the hospital setting. WIC state agencies and hospitals can partner to establish policies to ensure that WIC participants receive in-hospital
education and support for breastfeeding, including identiication of a WIC peer counselor and scheduling of follow-up support for breastfeeding by WIC staf in the community.

Getting Involved

We try to work as closely as we can with our local hospitals and physicians.  We deliver rental breastpumps to patients in their hospital rooms at Crestwood Hospital. Our Postpartum Support program is a tremendous resource for new mothers who don't have family nearby to help them after baby is born.

Our Bosom Buddies program is specifically designed to help WIC moms by providing them nursing bras. Furthermore, our sliding scale for lactation consultation services in our office ensures that no mother who needs help will ever be refused it due to her inability to pay for an IBCLC.