Reflections on my First Four Months as an IBCLC in Private Practice

I sat the IBCLC exam in October 2016, got my results in December (passed with flying colours!) and started working in Private Practice at the end of February 2017. I wasn’t quite sure what to expect when I requested to be listed on the ALCI website, but I was chomping at the bit to start working and doing what I love – helping and supporting breastfeeding families. I got a call the very next day from a mother who was struggling to breastfeed her 4 day old baby. After arranging to visit her, the panic and the fear set it. Would I actually be able to help this mother? Should I ask a more experienced IBCLC to visit her instead? Doing the consult was a terrifying prospect to me. I felt so utterly insecure and lacking in confidence, yet at the same time I was determined to make the leap and do my first consult.  I was almost sick with anxiety before the consult, but I did my best to appear calm and professional when I arrived at her house. To be honest, I felt like I was pretending. A kind of paralysis gripped me while I was with her. I was terrified of saying the wrong thing and of ‘failing.’ But when I reflect on this visit now, I realise I did kind of ok. I helped the mother to get her baby latched and feeding well. And she was happy at the end of the visit.

I’ve had a very busy few months since then. It has been a huge learning curve for me – bigger than I could ever have imagined – but it has been extremely interesting and rewarding. I’ve learned something from each mother-baby dyad I’ve worked with, and have felt privileged to get to know them. And here are some of my reflections from my first 4 four months working as an IBCLC in PP:

As a new IBCLC in private practice, having the support and guidance of more experienced lactation consultants has been invaluable to me. I simply could not have done this without the support of two ladies in particular, Sue Jameson IBCLC and Fiona Rea IBCLC (both of whom I know through the volunteer support organisation Cuidiu). They have both given me lots of encouragement and have always been available to chat and share insights when I have had a particularly difficult consult. They’ve been very generous about sharing their experience and wisdom with me. I have also benefitted from the support of other IBCLC’s in a couple of closed Facebook groups.

I’ve had to learn how to manage my own expectations, understand the mother’s expectations and also remind myself not to expect too much from babies. ‘Success’ doesn’t always mean exclusive breastfeeding. It can mean making a decision to continue pumping and bottle feeding, formula feeding and bringing baby to the breast for comfort, at the breast supplementation with formula, or making a decision to wean. It’s about meeting a mother where she’s at and helping her have an experience of breastfeeding or not breastfeeding that she is happy with. One client I saw had had a very traumatic birth. and subsequently her baby wouldn’t latch. She did some pumping and bottlefed a mix of  formula and breast milk. I saw her when her baby was a week old, and ‘my’ goal was that we would get baby feeding at the breast. The result, however, was that she decided to continue pumping. She said she just wasn’t “in the right headspace” to try feeding her baby at the breast. And this only transpired during the course of the consult. We talked about how enjoying her time with her baby was more important than anything, and the benefits of doing skin-to-skin and baby wearing. And she felt happy with her decision.

Most of the Dads/partners that I have met have been amazing. It has been heartening to see just how committed so many of them are to being involved with their baby in the early weeks and how supportive they are of breastfeeding. I just love when the dads are present for the consult. They usually have lots of questions for me and some even sit and take notes. One of the books I often recommend they read is ‘Our Babies, Ourselves’ by Meredith F. Small. I have had a couple of consults recently where the Dads proudly informed me that they hand expressed colostrum for their partners. According to one Dad, “it’s just like squeezing toothpaste from a tube!.”

Birth trauma. It really upsets me to see two parents who are totally traumatised by the experience they have had in the hospital. It makes me angry. I actually cried during one consult. The mother started to tell me in detail about her birth experience, and hard as I tried to maintain my composure, tears started to roll down my face. Even now, as I recall this consult and this couple, I am starting to well up. Far too many mothers are being induced for non-medical reasons and this, I believe, is one of the contributing factors to the high level of instrumental deliveries and C-sections. When starting out in private practice, I wasn’t quite prepared for just how much raw pain and trauma I would encounter on home visits. Sometimes just listening and holding space for a couple as they detail their birth experience can take up more than half of the consult. And that’s ok. It’s part and parcel of this privileged work that IBCLCs do.

I’m still in the process of figuring out how I can care for myself, both physically and emotionally. Physically, I’m feeling like a bit of a wreck at the moment. I did something to my back last week and could barely walk for a couple of days until I saw a physical therapist who sorted me out. I think it was my body’s way of letting me know that I need to give more consideration to my own comfort and ergonomics on home visits eg avoid perching on the edge of a mother’s bed (not good for the lower back!) and sitting in a position where I have to twist around to speak to the mother and see baby feed. As far as supporting myself emotionally is concerned, I haven’t totally figured that one out. I find it hard to switch off and often I’ll wake at 3am wondering how a particular mother and baby are doing or if I missed something. But I’m sure I’ll get there. I’m learning every day. And looking forward to going on holidays next week to recharge my batteries and spend time with my family.

Finally, the babies. The babies are what ultimately make this work so enjoyable. Each of them is so unique and precious and full of personality. Each time I think I have seen the cutest and most adorable baby ever. And then I go to my next consult, and  I’m smitten all over again. These little people are the future, and to be doing work in which I help parents care for them and have a mutually enjoyable experience of early parenthood gives me so much joy.

Comments

  1. Loved your blog Caoimhe. Really interested in all the options you explored. Liked in particular the mother who used the time as bonding with her baby, skin to skin, and no pressure to breastfeed. Looking after yourself is important too as reflected in your back pain. When I had Ewan I breastfed for a short period but was driven nuts by a family friend who was a district nurse and took it on herself to call every day and wake Ewan to weigh him to see if he was putting on weight. I know she meant well but it ruined my confidence. Thank goodness for people like you today. Agree with you about inducing labour, it’s scandalous and still goes on. Just a thought how did women manage 100 years ago. I suppose breastfeeding was totally natural and no alternatives available. Most women wouldn’t have money for formulae if such a thing existed. Well done on becoming a IBCLC, a big career change from your 20s!

    1. Hi Eileen, the post-partum period is such a sensitive and vulnerable time for new mothers….and their confidence can very easily be shattered. There was no real support to breastfeed when you had the boys, because bottle feeding was just what everyone did. It was a very different experience for me when I had my kids – lots of breastfeeding support groups and people to turn to when it felt like things weren’t going great. One of the big challenges for new mothers now is not having enough support, eg women in their family or community may not have breastfed. Whereas a hundred years ago, we would have grown up with breastfeeding being the norm and would have had mothers, sisters, aunts, friends etc around us giving us guidance and imparting wisdom that had passed down through the generations.

  2. Hi Caoimhe, thank you for your kind words. I am only to happy to pass on knowledge, and to support you on this journey as others did for me many moons ago. Ensuring a good start for NQ IBCLCs is part of succession planning and allows us oldsters to see new growth and vigour in the profession we started in Ireland 28 years ago. It has been, and continues to be the most rewarding and also, at times the most challenging thing I have done. It has changed my life ( mostly for the better) and never worry about a shared tear with parents. It can often validate a shocking and traumatic experience when they see how much their story affects a total stranger. Rock on my friend, you’re doing just fine.

    1. Thanks Sue. You’re always so generous with your time and your knowledge. I hope that some day I’ll be able to do for new qualified IBCLCs what you’ve done (and continue to do) for me 🙂

  3. Hi Caoimhe, I’ve just found your blog and it’s fantastic. Well done of becoming a lactation consultant, very exciting. I’m actually thinking of becoming one myself so am really interested to hear what route you choose to get there. I have no medical background (currently work in Marketing) but am passionate about breastfeeding, providing support to new mothers and increasing breastfeeding in Ireland. I have two small girls who were both exclusively breastfed. My first was born in London, where we had a huge support from health nurses and free lactation consultants. My second was born in Dublin and I had a completely different experience. It’s led me to rethink my current career and do something I’m genuinely passionate about. I would also like to improve the services to new mothers, engage with the government to increase funding for breastfeeding services and better support for new mothers in Ireland.

    I’ve researched how to become a Lactation Consultant as that’s my goal but it doesn’t seem very straight forward so I would really like to hear your story please.

    Thanks

    Avril

    1. It’s not that straightforward Avril! Getting involved with a local breastfeeding support group (LLL or Cuidiu) would be a good place to start. I wrote this blog last year about the voluntary counsellor route to becoming an IBCLC http://www.alcireland.ie/the-voluntary-counsellor-route-towards-ibclc-certification/. Hopefully this will give you a clearer picture of what’s involved in attaining the qualification. When I first left university, I worked as an electronic engineer (hated it)….but motherhood took me on a very different path, one that I never would have envisioned. Best of luck, Caoimhe

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