A couple of years ago at the Association of Lactation Consultants of Ireland annual conference, one of my IBCLC colleagues, Sue Jameson, facilitated a very good workshop on the pros and cons of working in private practice as a lactation consultant/IBCLC. Attendees brainstormed during the session to come up with two big lists – the pros and the cons. I don’t have copies of those lists now, but I’m going to draw up my own pro and con lists, based on my experience thus far working in private practice.

 

The Cons:

• Private practice work can be lonely. You don’t have colleagues to turn to when you’re working to ask for a second opinion, and you’re not part of a structure such as the HSE and all that goes with it.
• In Ireland, the amount of money you can earn from private practice is limited. It’s quite a niche market.  Most IBCLCs in private practice that I know also do some other kind of work to supplement their income. For me, private practice work is part-time, and certainly not an income I could support a family on. I’m only able to do private practice because my husband works full-time and has an income that we can live on.
• It can be unreliable eg some weeks you might have lots of work and the next you have none. You just never know. So you have to be prepared to roll with that and make the most of the quiet times. There is no certainty (at least in my experience!) that you will have x number of consults booked in in any given week.
• And following on from the above point, when you don’t work you don’t get paid! There is no holiday pay and no sick pay.
• The costs of staying in private practice and maintaining IBCLC accreditation are quite high, relative to earning potential.  Eg insurance, supplies (nipple shields, feeding tubes etc), conferences/CERPS, maintaining website, and 5 yearly recertification with IBLCE, the current cost of which is $470.
• Sometimes the work is challenging. When it’s good it’s good, but when you don’t get the outcome you’d hoped for (eg a baby who just refuses to latch or a low milk supply that doesn’t increase despite best efforts) it can weigh heavy on you.
• Working in private practice can be emotionally challenging. You see a lot of clients who have had very difficult birth experiences and in some cases poor breastfeeding support (which may have had a detrimental impact on their breastfeeding journey). You might also sometimes find yourself holding space for a parent who has experienced infant loss or a fatal foetal anomaly. So it’s hard not be be affected and not to carry some of the emotions you’ve felt during the consult with you into your day to day life. Emotions such as sadness, grief, and anger. I have found that I have become more skilled at processing these emotions as time goes on, but this is something I have worked on by paying attention to self care and by attending one-to-one counselling sessions for reflective supervision.
• Sort of related to the above point, but he headspace that private practice work takes up is big!

The Pros:

After reading the above you might be forgiven for wondering why anyone would want to go into private practice, but there are lots of pros! Here’s some of them.

• The babies! This has to be the biggest pro of the job, seeing and getting to cuddle gorgeous babies, all of whom have their own unique little personalities.
• The Parents! I love meeting new parents. Sometimes it’s the just the mum I meet at the consult and sometimes her partner is there too. I love hearing their stories and seeing/feeling the love and awe they have for their new little person, and experiencing the oxytocin buzz in the home.
• Being able to help with breastfeeding – stating the obvious here, but it’s wonderful to be able to play a role in helping a mother have a more positive experience of breastfeeding than she would have had had she not seen you. And it’s very rewarding to know that in helping with breastfeeding, you are helping a baby have more breast milk and more optimal health outcomes. Making a difference to one dyad at a time 🙂
• Helping parents to understand newborn behaviour and giving them skills and knowledge that can help make the early days with their newborn easier and more enjoyable.
• The work is always interesting and you always learn something new from each family you work with.
• You are your own boss and the only people you are answerable to are your clients. You can decide when you will work and for me this means being able to arrange work around family life.
• The camaraderie and support of fellow IBCLCs. I couldn’t do what I do without the friendship and support of colleagues. I have met so many strong, wonderful, generous and inspiring women through this line of work and for that I feel grateful.
• Continuous learning in the form of conferences, such as the annual ALCI Conference and the annual LC in Private Practice Conference in Philadelphia.
• Getting to do something you love, it’s such a privilege.