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Nurses have the opportunity to take on new and advanced roles through certifications and degree programs. For nurses working in maternal/child health, a lactation consultant is one such role to pursue. A lactation consultant, formerly titled IBCLC (International Board Certified Lactation Consultant), is a health care professional who may work in a variety of health care settings and specializes in the clinical management of breastfeeding. IBCLCs have been proven to improve breastfeeding rates, lower health costs, and improve consumer satisfaction and trust.

Many nurses and the general public may not know exactly what a lactation consultant does on a daily basis. Daily Nurse interviewed Robin Franzoni, a lactation consultant at a teaching hospital in central New Jersey. Robin worked as a NICU nurse for many years before she became an IBCLC. Here is what she had to say.

What first sparked your interest in becoming a lactation consultant? When were you first exposed to an IBCLC?

My passion reaches back to when I was a new mom and getting ready to nurse my first child. My mother nor my aunt ever breastfed. I was one of the first one of my friends to have any children. My exposure to breast milk and pumping while working in the NICU was what really spurred my own decision to breastfeed. There were no lactation consultants at that time, but I saw how much better the babies did on their own mothers’s milk. I had horrible pregnancies and preterm labor with all three of my kids but I felt like the one thing I was successful at was nursing my own kids. So my success at breastfeeding and exposure in the NICU is what kind of gave me the interest.

What would you say your typical day is like? What are your day-to-day responsibilities?

I see my discharge patients first and make sure they’re going home with all their questions answered and information for follow up after discharge, especially the ones who have had some difficulty latching or feeding or are losing too much weight. Then I see all the first time moms and assess the latch and get them motivated to start positioning the baby themselves. A large part of it is preparing them for what’s expected at home because they have such a short time in the hospital. Then after I’ve gotten through most of the first time moms, I see any other mothers having difficulty or who  have asked for a consultation. But really my first priority is seeing, stabilizing, and supporting the first time mother.

What’s your favorite part of your job?

I think being the person who has gotten a baby on for the first time or seeing a baby who’s been struggling and all of a sudden it clicks and they start eating. And the look of mom’s wonder on her face like, “Oh my gosh, it’s kind of happening.” I’ve been to hundreds of deliveries over my career and it used to be so exciting to watch a baby being born and they take that first breath. Seeing that baby eating for the first time is just as thrilling as watching the baby being born. It’s the culmination of many different things that are finally in perfect sequence and everything clicks and to me it’s really wonderful. It’s establishing that connection with the baby by nursing that is not only for the nutrition but the connection with the baby.

What’s the most challenging part of what you do?

It’s the preconceptions people have that negatively impacts nursing. It’s unrealistic expectations and misinformation the mother has received from family members or friends. It can be like trying to knock down a barrier that’s been erected around themselves. But I think it’s mostly the lack of good education about breastfeeding.

How do you work together with nurses when giving care to a patient?

Well, I feel that I’ve been really fortunate. I developed this routine that after I’ve seen the mother and the baby I usually go to the bedside nurse. And I think it’s just evolved into what I do because I’m counting on the bedside nurse to carry the ball after I’ve left. The reality is I’m probably only going to see that patient once on day 1 postpartum and at discharge. So the rest of it falls onto the bedside nurse. Teamwork gets it done. I want every nurse to feel that she is part of the breastfeeding support and that I’m depending on them and trusting them. 

Do you have any advice for nurses who may want to become an IBCLC?

I think they need some really good mother/baby or NICU experience first.  I think you need a base and then after building that base then think about doing it. It’s something I really think you have to have a passion for because it’s one of the toughest things I’ve done to date. I thought it would be less stressful than the NICU, but it’s just a different kind of stress. You’re shouldering not only the baby and assisting them, but you’re also responsible for the emotional well-being of the mother and part of the physical well-being.

If you are interested in learning more about the professional role of a lactation consultant you can visit www.uslca.org or www.ilca.org. Information about obtaining certification can be found at www.iblce.org.

Allison Flynn, BSN, RN, IBCLC

Allison is a practicing RN and lactation consultant. She will be graduating this year with a master’s degree focusing on nursing education.

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