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Lactation Consultation

Category

Child & Family Health

Child's Age

Prenatal, 0-1 years, 1-2 years, 2-3 years, 3-4 years, 4-5 years

Participant

Parents/Guardian

Languages

English

Brief Description

Lactation consultation is provided by International Board-Certified Lactation Consultant (IBCLC) or Certified Lactation Counselor (CLC). Lactation Consultants offer support, advice and guidance to people who choose to breastfeed and can help with painful nipples, milk supply, breastfeeding positions and other common nursing problems. Implementation should include community awareness of UNC’s hotline: Breastfeeding Warmline, (984)-974-8078 or toll free at (866) 428-5608) for anyone living in NC.

Expected Impact

  • Increase in breastfeeding initiation
  • Increase in exclusive breastfeeding rates
  • Increase in rates of any type of breastfeeding

Core Components for Model Fidelity

  • Lactation Consultation: International Board-Certified Lactation Consultant (IBCLC) or Certified Lactation Counselor (CLC) provide lactation consultation to breastfeeding parents/caregivers. Support provided by trained IBCLCs or CLCs may include:
    • Providing interventions to improve breastfeeding outcomes, such as helping the mother and baby with latch and positioning, painful nipples, milk supply, and other common nursing experiences.
    • Counseling mothers on returning to work or school.
    • Addressing other concerns of the mother and their family.

Languages Materials are Available in

English

Delivery Mode

In-person consultation is most commonly provided during medical appointments, home visits, community venues. Consultation with an IBCLC or CLC may also be offered virtually.

Dosage

Dosage varies depending on the needs of the participating parent/caregiver.

Infrastructure for Implementation

Space: Consultation requires a designated and private meeting space.

Staffing Requirements

International Board-Certified Lactation Consultant (IBCLC) or Certified Lactation Counselor (CLC) IBCLCs may come from a healthcare background or any professional background if they complete the required training. The International Board of Lactation Consultant Examiners provides three pathways for IBCLCs prior to completion of the IBCLC Examination. The Board also offers a registry of all IBCLCs. The Academy of Lactation Policy and Practice also provides three pathways for CLCs prior to completion of the CLC Examination. The Academy also offers a registry of all CLCs. 

  • International Board-Certified Lactation Consultant (IBCLC): Completes over 90 hours of education as well as clinical hours and health science courses; passes a board certification exam; highest level of lactation care offered.
  • Certified Lactation Counselor (CLC): Can answer basic breastfeeding questions, assist with latching, and provide a referral to an IBCLC; may act as a steppingstone to becoming an IBCLC.

Training for Model Fidelity

Recommended programs in NC that prepare and support IBCLCs are listed below. 

  • North Carolina Agricultural and Technical State University: HUMAN LACTATION PATHWAY 2 CERTIFICATE - Post-Baccalaureate Certificate
    • Prepares students to become an International Board-Certified Lactation Consultant (IBCLC)
    • Focuses on increasing breastfeeding among minority communities, especially for African Americans
    • 95 didactic hours of coursework and 300 hours of clinical experience (as required by IBLCE)
    • 18 credit hours (can be completed in one academic year)
    • Department of Family and Consumer Sciences
    • Application requirements: 1) must have a bachelor's degree, 2) must complete the 8 Health & Science Requirements, and 3) applications are due February through April  
  • The Mary Rose Tully Training Initiative (MRT-TI) at the Carolina Global Breastfeeding Institute (UNC Chapel Hill - Gillings School of Global Public Health): Comprehensive Pathway 2 Lactation Consultant Training Program
    • Prepares students to become IBCLCs
    • Encourages students to attend the Minority Health Conference
    • 95 didactic hours of coursework and 300 hours of clinical experience
    • Application requirements 1) must be a health professional or have a bachelors in specific health fields and 2) applications are due by the end of April (may include other requirements)
    • MRT-TI was the first pathway 2 (P2) lactation consultant training program in the US to be accredited by the Commission on the Accreditation of Allied Health Education Programs (CAAHEP) fulfilling requirements set by the IBLCE
    • https://sph.unc.edu/cgbi/lactation-consultant-training/

Contact Information

International Board of Lactation Consultant Examiners (IBLCE) in the Americas & Israel: 703-560-7330; ibcle@ibcle.org

https://www.ncbfc.org/

Cost Estimates

Cost of training and licensing for IBCLCs or CLCs varies by program.

Purpose Service Code (PSC)

5413 – Prenatal/Newborn Services

Program Identifier (PID)

Lactation Consultation

Minimal Outputs for NCPC Reporting

FY 24-25:

  • Number of parents/guardians participating† 

†Select Family Support Programs data collection will include basic demographic data for parent/guardian participants including Race, Ethnicity. Data on interpretation and transportation will be collected when appropriate.

Minimal Outcomes for NCPC Reporting

FY 24-25:

  • Increase in parent use of services

Minimal Measures for NCPC Reporting

FY 24-25:

  • Parent Use of Services Calculation 
  • Please add a write-in depending on what the participants are focusing on 

NCPC Evidence Categorization

Evidence Based- 1 meta-analysis of 16 randomized control trials.

Research Summary

One of the most relevant publications on the effects of lactation consultation is a meta-analysis evaluating breastfeeding outcomes.1 The outcomes reported were breastfeeding initiation rates, duration, any breastfeeding rates, and the rates of exclusive breastfeeding, as well as possibly including infant health outcomes and maternal health outcomes. Results showed that the interventions increased rates of breastfeeding initiation. As for breastfeeding duration, interventions were shown to increase median and mean duration, including exclusive breastfeeding. Effect size varied for any breastfeeding rates depending on the setting, however interventions were still shown to be beneficial for up to 1 months, 1 to 3 months and between 3 and 6 months. For exclusive breastfeeding, interventions had positive effects for up to 1 month, and from 1 to 3 months, however there were no statistical effects for between 3 and 6 months. As for the secondary outcomes' measures, one study that measured infant health care outcomes found no statistical effect related to breastfeeding support. However, the breastfeeding support interventions did show statistically significant improvements in measures of breastfeeding success, nipple pain, and nipple trauma in the one study that considered maternal health outcomes. There were differences in the interventions used in each of the studies but, overall, the results showed that lactation consultants and counselors had beneficial effects on breastfeeding rates and initiation. Some interventions were conducted as prenatal education, some did not include education, and some provided support by either phone or face-to-face. The number of studies was too limited to allow for conclusions on breastfeeding duration and maternal/infant health outcomes. Overall, the meta-analysis concludes that practices serving low-income populations should consider adding lactation consultants/counselors and provide programs that could be delivered in a hospital, clinic, or home face-to-face or over the phone. 

The North Carolina Breastfeeding Coalition (NCBC) provides information on the North Carolina Lactation Consultation Association (NCLCA), Medicaid billing, licensing, and other important resources for lactation consultants and individuals interested in receiving services. 

  1. ^ See Patel and Patel (2016). The studies included in the meta-analysis are randomized controlled trials on the antenatal education/postpartum support provided by lactation consultants or counselors that were conducted between 1985 and 2014. The studies included the use of IBCLCs, CLCs, lactation consultants, or lactation counselors that supported women through breastfeeding programs. Comparison groups may have included breastfeeding support provided by midwives, nurses, physicians, peer counselors, or no interventions offered. The programs provided support though education, health care teams/systems, or counseling. The populations in these studies include participants from a wide variety of racial/ethnic backgrounds. Most were considered low-income, and the interventions were completed in urban medical centers or university hospital clinics. The majority of the studies included were considered to have low amounts of bias, the exception being 5 studies that did not blind their outcome assessors. When these studies were excluded, the results still showed beneficial effects for breastfeeding initiation, as well as any breastfeeding and exclusive breastfeeding.

Researched Population

  • Industry Standard
  • People of various racial/ethnic backgrounds
  • People with lower incomes 
  • People living in urban areas

North Carolina Breastfeeding Coalition. (n.d.). Home | ncbc. https://www.ncbfc.org/

North Carolina Breastfeeding Coalition. (n.d.). NCLCA | NCBC. https://www.ncbfc.org/nclca 

Patal, S. & Patal, S. (2016). The effectiveness of lactation consultants and lactation counselors on breastfeeding outcomes. Journal of Human Lactation, 32(3), 530-541. https://www.doi.org/10.1177/0890334415618668

Please see the Smart Solutions entry for Lactation Peer Support Groups and Lactation Education.



Local Partnerships Currently Implementing

Local Partnerships in purple have adopted Lactation Consultation. Local Partnership contact information can be found here.