Certified Lactation Counselor Training

A couple weeks ago I did my training to become a Certified Lactation Counselor. I knew probably about 80% of it already (since I am a voracious reader of birth/breastfeeding blogs and academic studies on evidence-based practices, and I have worked with breastfeeding moms), but I also learned a lot, too.

Some of the new and awesome things that I learned in CLC training:

1. Babies can detect breast cancer (WTF): There is something called Goldsmith's sign, which is when a baby might be detecting undiagnosed breast cancer. The baby refuses to nurse on one breast. If other reasons such as ear infection, teething, birth trauma, etc are ruled out, breast cancer might be a possibility! And cancer may be diagnosed as late as 5 years after this sign from baby.

2. Breastfeeding provides protection for LIFE: When mothers who breastfed their baby donated a kidney to their adult child later in life, the adult child had less organ transplant rejection (compared to mother-child pairs that had not breastfed). The same protection was afforded when there was a sibling --> sibling organ or tissue transplant, if they had breastfed.

3. Powdered formula is not a sterile substance:  It must be prepared at a temperature of at least 158 degrees F (and then cooled) before being fed to an infant, and you should not prepare a large amount ahead of time. A powder cannot be sterilized, and formula has been found to contain harmful microorganisms from time to time.

4. Colic = crying for more than 3 hours/day for more than 3 days/week, for greater than 3 weeks. I didn't know that definition!

5. Great resource! How to Safely Co-Sleep: The UNICEF UK Baby Friendly Initiative have a helpful pamphlet on how to safely sleep or co-bed with your baby. This is more than the U.S. provides, as they just say "don't do it," but people do it anyway, and do it unsafely.

Of course I learned a lot of other things, too, but less new and less awesome (and thus not worth sharing here). But in case you're interested in what the training covered...


On the first day we covered: International and national breastfeeding policy context, evidence-based practice, lactation credentials, examination of factors influencing success at breastfeeding, national perspectives on breastfeeding rates, anatomy and physiology of lactation, hormones of lactation, composition of human milk, gastrointestinal hormones of lactation, distinct weight gain patterns of breastfed babies, and myths about milk supply.
On the second day we covered: The effect of substances and objects on milk supply, the effect on milk supply of hypoglycemia, jaundice, latch-on, engorgement, implants, effect of milk supply of discrepant breast size, breast surgery, inverted nipples and others, counseling women with fears about milk supply, approaches to use in patient education with different types of learners, health outcomes associated with infant feeding choice, safer use of infant formula, and donor milk banking.
On the third day we covered: Application of social psychology theory to lactation counseling, influencing the infant feeding decision, men's concerns about breastfeeding, enhanced effectiveness through lactation counseling skills, supporting the mother's desire to breastfeed exclusively, the impact of maternity care practices on breastfeeding outcomes, parameters of feeding assessment, and strategies that have been found to be effective in assessing breastfeeding.
On the fourth day we covered: Strategies for dealing with the challenge of breast problems, milk expression, milk storage and handling, supplemental feeding methods for the breastfed baby, working women and breastfeeding, strategies for building or maintaining a milk supply under challenging conditions, galactogogues, strategies found effective for assisting babies with special challenges, effect of breastfeeding on amenorrhea and fertility, the effect of foods in the mother's diet on the infant, the effect of alcohol, caffeine, and environmental contaminants on mother's milk, the impact of medications on the infant, and contraindications to breastfeeding.
On the fifth day we covered: Early support in the "zone of professional unavailability," common concerns after the early weeks - ages and stages, vitamin supplementation, complementary feeding, weaning, nursing older babies, nursing strikes, ethical issues in lactation care, and the Baby-Friendly Hospital Initiative


A lot of people in my course were new to working with breastfeeding moms - many people from the community, some people in public health, a few from Healthy Start-type positions, a handful of doulas, but only one nurse. I have realized this is not the normal audience for this type of class, which is generally mostly people from medical backgrounds. Elita at Blacktating writes about her course, which had a different audience, but was structured similarly to mine.

The organization that runs the course, The Center for Breastfeeding, has claimed that the CLC certification is equal to the IBCLC training in that both are "entry level." You can read more about their opinion here: Position Paper on the Comparative Roles and Training of the IBCLC and CLC. Basically they believe that since the CLC course has not only an exam that must be passed, but also several competencies, that it is just as good a training as the IBCLC, where "anyone can take the exam" and there are no competencies. I beg to differ. The IBCLC certification requires over 1000 clinical hours, in addition to certain pre-requisite education on anatomy/physiology, etc, and the CLC training does not require any. I imagine this is all part of a political rivalry between the two certifying organizations.

I'm glad to have added this training to my skill set, and anxiously await the results of my exam!