Breastfeeding Medicine: Providers’ Roles

If you’re trying to breastfeed (chestfeed) your baby, and it’s not going as you expected, you’re not alone. In fact, you’re in the majority. But help is available.

“About 70% of people who attempt to breastfeed will have challenges at some point in their breastfeeding journey,” says breastfeeding specialist Heidi Szugye, DO. “Some of these challenges can easily be overcome with some support from a breastfeeding provider.”

Dr. Szugye discusses how different types of breastfeeding providers can help you through your breastfeeding challenges.

Breastfeeding medicine specialists, providers and counselors

Before breastfeeding specialists and lactation consultants existed, new parents would receive help from friends or family members. “But as our lifestyles have changed, there’s been an increasing need for breastfeeding support,” says Dr. Szugye.

When commercial baby formula became available in the U.S. in the 1950s, companies heavily marketed it as superior to breast milk, and there was a trend away from breastfeeding. “But as we’ve learned more and more about the benefits of breast milk and breastfeeding for babies, the rate of breastfeeding has gone up,” she shares.

Several types of breastfeeding providers may receive certifications from a variety of organizations. And different providers have different roles, and they vary accordingly.

Breastfeeding medicine specialist

A breastfeeding medicine specialist, or breastfeeding medicine physician, is a relatively new specialty among healthcare providers. “In the past, there wasn’t a true breastfeeding specialty within the medical field,” notes Dr. Szugye. “A provider such as a pediatrician, family medicine physician or obstetrician could become an International Board Certified Lactation Consultant (IBCLC) and call themselves a breastfeeding specialist.”

But in 2023, the North American Board of Breastfeeding and Lactation Medicine (NABBLM) created an official breastfeeding medicine specialty. NABBLM now offers an exam for credentialing licensed physicians.

The requirements for a breastfeeding medicine specialty make it the most rigorous breastfeeding certification available. Providers, like Dr. Szugye, need:

• A medical license
• Education credits
• 1,000 hours of experience with breastfeeding people
• Three years of breastfeeding-focused medical practice

“This specialty really came about because a lot of breastfeeding problems and challenges require physician-level support,” says Dr. Szugye.

If the problems require diagnosis and treatment, only a physician can provide these.

“I’m a big proponent of treating breastfeeding like we do anything else in medicine. If someone comes in with a problem, we do a full workup, take a history, do tests and exams. Then, we can come up with a diagnosis and a plan for treatment and follow-up,” she explains.

But not every breastfeeding problem requires medical treatment. Depending on your needs, other breastfeeding providers and counselors can provide the right level of support.

Lactation consultant

“‘Lactation consultant’ is kind of a catch-all term for several specific certifications,” says Dr. Szugye. Lactation consultants may have titles such as:

• Certified breastfeeding counselor
• Certified breastfeeding specialist
• Certified lactation counselor
• Certified lactation specialist

A lactation consultant typically takes lactation management courses and completes the required education and experience hours to receive their certification. Different hospitals have different requirements.

A lactation consultant usually provides inpatient support to parents and babies in the hospital. They also often offer one-on-one appointments where they:

• Assess your baby’s ability to latch
• Help with pumping and supplementing with formula
• Provide breastfeeding tips and advice
• Weigh the baby before and after feeding to see how much milk your baby consumes

Lactation consultants may also:

• Run breastfeeding support groups
• Teach classes on breastfeeding

Lactation educator

Certified lactation educators typically provide instructional classes, usually in a group setting.

“They’re often teaching pregnant people or people who’ve just had babies about breastfeeding, the benefits of breastfeeding, and how to latch a baby and positioning,” shares Dr. Szugye. “But they’re not providing hands-on care or documenting anything in medical records.”

Breastfeeding peer counselor

Organizations such as La Leche League offer breastfeeding peer counselor certifications.

“Peer counselors are people who have breastfed their own babies and want to help others with breastfeeding,” explains Dr. Szugye. “It’s a bit like a mentorship program.”

Requirements for peer counselor certification vary depending on the organization issuing the certification. A peer counselor can offer nursing parents basic information, encouragement and support. A peer counselor typically isn’t a licensed medical professional and can’t provide medical services or hands-on care.

Where should you start for breastfeeding support?

If you need breastfeeding support, your pediatrician or obstetrician is a good place to start. Your provider can help determine the level of assistance you need and find the right match.

Dr. Szugye advises ensuring any breastfeeding provider you see has a credential for their role. And if things aren’t getting better, know that there are other levels of help you can seek out.

“I’ve never heard anyone say they’ve had too much breastfeeding support,” she says.

Bottom line? Whether you need encouragement, guidance, hands-on help with your baby or medical treatment, there’s a breastfeeding provider who can help.

Breastfeeding — like most aspects of parenting — isn’t always a picture-perfect experience. But with so many professionals who can help, you don’t have to deal with the challenges alone.