Imagine spending months looking forward to breastfeeding, taking a class and reading every book only to find yourself struggling to feed your baby.  As a Certified Breastfeeding Counselor (CBC) you are likely to run into parents wondering how to manage when breastfeeding doesn’t work as planned.

Breastfeeding is our biological norm so it should come naturally and quickly to all, right? Unfortunately, no, it does not always come easily. During your CBC training you’ll learn all about why things don’t always happen easily. You will learn that breastfeeding doesn’t work as planned for everyone.

What Happens When Breastfeeding Doesn’t Work As Expected?

While most mother baby pairs can exclusively breastfeed with proper support and education, some pairs have unfortunate hurdles (maybe even mountains) standing between them and exclusively breastfeeding.

Certainly, our birth culture can and does impact feeding. Some common delivery and postpartum practices can complicate early feeding. For some pairs though, regardless of delivery and postpartum experiences, breastfeeding is unfairly challenging.

When breastfeeding doesn’t work as planned, many parents feel overwhelmed. They may be discouraged, disappointed, or inadvertently blame themselves. As a CBC, you can provide emotional support as they navigate their options.

When breastfeeding truly doesn’t work as expected, some underlying issues will be beyond the scope of a CBC. However, if they’ve addressed these concerns with the proper professionals, you can come alongside and help them with implementing care plans.

What Causes Breastfeeding Difficulties?

Unexpected NICU stays, tongue ties, insufficient glandular tissue (IGT), thyroid conditions, a baby with poor muscle coordination or developmental difficulties, can all impact desired breastfeeding goals.

For these pairs, breastfeeding can become a bittersweet part of their lives. Some choose to employ every possible aid, while others decide to formula feed, and many fall in between and combo feed. There is not a right or a wrong, every pair and lifestyle varies.

What Should I Do As A CBC To Help?

Whether one experiences minor or mountainous breastfeeding challenges, it’s always difficult when things go unexpectedly. The first step when challenges arise is for her to seek help and to come up with a plan with professionals.

As a CBC, you can chat with the client to see if her concerns fall within your scope of practice. If she is struggling with breastfeeding issues related to outdated advice or miseducation, you can help with evidenced based information. Perhaps the parents need reassurance about common newborn behaviors and understanding the difference between expected behavior or concerns.

If things fall outside your scope as a CBC, an IBCLC lactation consultant can help the client further decipher between common breastfeeding challenges and challenges that might require a second opinion for diagnosis (tongue ties, IGT, thyroid, etc).

Remind clients that if they see a lactation consultant, physician or other professional and they’re not confident in the recommendations, they should never be afraid to seek a second or even third opinion.  Intuition is a powerful thing!

Offering Ongoing Support

Once they know what is going on, their next step is to develop a plan. If breastfeeding exclusively or in part remains important, despite any diagnosis, there are options available to help them reach their goals.

Some families opt to exclusively pump and bottle feed. Some utilize their pumped milk, formula or donated milk from another mother in a supplemental nursing system (SNS). An SNS ensures a certain intake while stimulating one’s breasts to maximize output. It is also great for bonding and infant oral development.

Traditional breastfeeding and using bottles of formula, pumped or donor milk to supplement is a common way to handle some challenges. Galactagogue herbs and medications are sometimes used in addition to pumping and feeding at the breast. As a CBC, you cannot recommend any specific herbs or supplements, but you can provide general information and encourage them to check with a qualified professional.

Developing a plan is not always difficult but maintaining one might be. Even without challenges life with a new baby is demanding and tiring. Remember to encourage and remind the parents they are doing amazing. Reiterate that however they feed their baby is amazing. Let them know that only they can decide their personal feeding goals and they should not feel pressured into one specific way of feeding.

Be an ear. Provide evidenced based support. Remind them they are doing amazing.