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“What can she do for me?”

Every “expert” who helps pregnant, birthing, and breastfeeding mothers has advantages and drawbacks. By knowing a little more about each kind, a mother is better able to choose the one she needs at any point in her mothering experience.

A midwife is usually trained in facilitating normal, unmedicated births, and her presence usually means a lower rate of complications. But she is not trained in surgical births, and the extent to which she can facilitate normal births may vary according to her workplace.

A doulafocuses on a mother’s comfort and well-being prenatally, during the birth, and perhaps afterwards. The level of a doula’s skill can range from a friend or relative who provides consistent reassurance to a certified doula with specific training. Her presence can be as effective as an epidural in making labor comfortable. But she is not trained in delivering babies herself. She may help with everything from fixing meals to tending the toddler. She is skilled at helping breastfeeding get off to a good start, and at knowing when breastfeeding requires more assistance. But she is not trained in giving that assistance.

A hospital nurse is trained to assist in hospital births, and has a medical background. But she may or may not have had experience with unmedicated births or with the needs and behaviors of an unmedicated breastfeeding newborn and mother.

A pediatricianspecializes in medical issues involving children. But she is unlikely to have had much training in medical school about breastfeeding.

A lactation consultant or breastfeeding specialistprobably has special training in recognizing and dealing with breastfeeding problems. But her title has no standardized meaning, and her levels of knowledge and skill are highly variable.

An international board certified lactation consultant (IBCLC)has completed several thousand hours of working with breastfeeding mothers, has passed an international exam, and must recertify every 5 years, assuring a standard level of skill. But her personal breastfeeding experience is highly variable. She can work as intensively as needed with a breastfeeding mother. But she usually charges for her services, she cannot replace the group support that breastfeeding mothers have always relied on, and she is not necessarily medically trained.

A La Leche League Leader.has nursed at least one child for a year or more, and has a reading-based background in birth, breastfeeding, and early parenting issues. She is skilled at phone help, finding and providing information, and facilitating gatherings of breastfeeding mothers. Her services are free, and she can help a woman find the mother-to-mother support that builds confidence and offers choices. But she is not usually a medical professional, and she isn’t usually trained to provide the intensive, highly skilled help that some situations require.

What do you need? . Help with medical care? With a standard birth? A sympathetic ear? Household help? Someone who can help you figure out why breastfeeding isnít going well? Someone who can help you fix it? When you match the helper to the need, you’re more likely to have a satisfying outcome.

©2000 Diane Wiessinger, MS, IBCLC www.normalfed.com

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