None of the greats do it solo. Why do we expect parents to?
2024 is an Olympic year. As the CEO of The Lactation Network, I watch competitions like the Games and the U.S. Open for the same reason many do: To see athletes perform herculean feats of strength and mental toughness; to watch people be celebrated for the hard work we see, and the hard work we don’t.
I’m also curious about the lives that support the humans on the podium (as well as the hundreds who never secure a medal). These coaches, trainers, medics, and mentors that comprise an Olympian’s support system have often-unsung roles to play. They bandage, diagnose, enhance, and support at every step in an athlete’s journey. These people represent the grit behind the gold — and in my work, I now know too well how close these parallels are to the lives of parents.
We often say ‘it takes a village’ to raise a child. I don’t believe it should take a village. Just like Olympians, the journey to welcome a baby (one of the most pivotal, challenging, joyous moments in life) takes a qualified, expert team.
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Villages imply families: Unpaid, obligatory support (that not everyone has). When we say parents should rely on that infrastructure to help them nourish their children and themselves, what we’re saying is that they should rely on the kindness of loved ones to care for them at a deeply vulnerable time.
Parents deserve more than that. I believe we need a reframe: Parents are not needy charity cases who must rely on a communal network. They are akin to professional athletes who deserve a coordinated team of expert care providers who work in concert to help them in the arduous, often fraught weeks, months, and years of their postpartum journey.
There’s a missing middle in the postpartum care experience. OB-GYNs care for pregnant people for about nine months through delivery, and pediatricians care for babies from weeks old through the age of 18. But neither will see both birthing parents and babies until six weeks post-birth.
That’s just forty-two days — but is an eternity for postpartum parents who are navigating a make-or-break period where post-partum depression, anxiety, and (as we see daily at The Lactation Network) challenges related to breastfeeding often run rampant. Who cares for both parent and baby as they learn how to feed and be fed? Enter the International Board Certified Lactation Consultant, or IBCLC.
Most people don’t know that breastfeeding is a skill that must be learned – and it’s learned during the first few days and weeks home from the hospital. Neither parents nor babies are born innately knowing how to give and receive. Part of that lack of knowledge is simply due to lack of visibility: Parents are often forced to breastfeed behind closed doors, deferring to Google searches to troubleshoot breastfeeding concerns. (It’s an interesting NIMBY-esque phenomenon in the U.S. — society says, sure, breastfeed, just not anywhere anyone should have to see it.)
The lack of knowledge is also due to a historical lack of inclusion of IBCLCs in traditional healthcare spaces — even though IBCLCs are the highest credentialed clinicians capable of caring for the parent-child dyad at a critical time for both.
OB-GYNs and pediatricians simply can’t do it all — nor should they. Doulas, midwives, lactation consultants, behavioral health professionals, pediatric dentists, and other team members are precisely who can chip in to assist on postpartum care teams.
IBCLCs fill a unique role on a family’s care team. There are nearly 20,000 IBCLCs in the U.S., and they’ve earned the highest certifications in clinical lactation care. Each receives extensive training, including hundreds of clinical hours, in breast and chestfeeding. They are often the first to flag signs of postpartum depression, and first to refer babies to specialists if required. Above all, they support parental autonomy throughout their breastfeeding journey: they meet the needs of those who breastfeed and use formula, as well as those navigating transitions like return-to-work or weaning.
But despite evidence that breastfeeding is crucial to support the health of babies and parents, the United States has the lowest breastfeeding rates among high-income countries. Why?
The Affordable Care Act (ACA) requires health plans to cover lactation care — but that coverage varies widely. Before the ACA, most families were paying hundreds of dollars out-of-pocket for breastfeeding support, making care inaccessible to underrepresented families. This means that both patients and physicians aren’t aware that insurance-covered care is an option, and traditional healthcare practitioners often don’t take advantage of the expert lactation guidance and support that so many patients desperately need. Plus, ten years after ACA implementation and many health plans are still not appropriately covering this care.
As a result, only 25% of infants in the U.S. were exclusively breastfed for the first six months. Babies who are breastfed are less likely to need emergency care for respiratory infections and GI infections, and are overall less likely to die before they reach their first birthday. Parents who breastfeed are less likely to contract certain types of cancer, diabetes, and heart disease.
With the right clinical support provided by IBCLCs, we can change the game for our parents and communities at large. What if we standardized an in-home visit with a lactation consultant soon after birth for all breastfeeding parents? What would our communities look like if an expert was still by their side through sleep training, returning to work, and starting solid foods? If we doubled the number of babies being breastfed through six months, the USDA estimates that at least $3.6 billion could be saved annually in treatment of childhood illness alone. Breastfeeding has also been linked to lower absenteeism at work, and greater productivity. More importantly, successful breastfeeding has been shown to improve emotional well-being and reduce rates of depression and anxiety.
Globally, we’ve spent weeks celebrating humans performing incredible feats of strength on the field, pitch, and court — and I argue that breastfeeding people and parents do the same, daily. They, too, deserve a supportive team to make the journey just a bit easier.
We’re here for you, every step of the way. We work with your insurance to provide in-home, in-office, or telehealth visits with an IBCLC.
