Read time | 12 minutes

I'm just going to start explosive, create a whole sh*t storm and say it...

No doula program provides adequate training on breastfeeding support.

Now I'm not saying that there aren't FANTASTIC doula training programs out there, nor am I saying that the breastfeeding training they do provide is bad. Yet, even with the most thorough labor or postpartum doula program, there's no way even a months-long doula course can adequately prepare doulas for providing high-quality breastfeeding support.

It was the experiences I had during my DONA doula training six years ago, as I planned to lay roots in the birth community, that planted the seed in my mind that breastfeeding and lactation might be my passion.

And at that time, because I was young and had "commitment issues," I decided to pursue additional training by other doula organizations, in both labor and postpartum doula support, all of which added to my understanding and ability to provide breastfeeding support.

To put how little knowledge I had about breastfeeding at that time, even after the training, I had only ever seen one person ( a fellow doula trainee) breastfeed in real life!

Following my initial breastfeeding encounter, I remember adding myself to birth and breastfeeding groups on Facebook and having a deep, visceral response of unease as breastfeeding photos popped into my timeline.

I clearly had a lot to unpack, but I digress.

Here we are nearing the end of 2019, I am now a seasoned doula and lactation professional, and I have had the privilege over the years of supporting new and aspiring doulas on their journey into the breastfeeding world.

Just this past week, I was talking to a new doula friend who was unsure if getting a breastfeeding certification would be helpful and worth the money. It was that conversation that inspired this post.

Compared to years past, more parents are seeking doula support.

This increase may be in part to the growing acceptance of doula support by health care professionals ( yay ACOG committee paper!) or the higher visibility by the media of the need for doula support in improving birth outcomes and reducing maternal and infant mortality.

In any case, as the rise in coverage AND popularity of doulas continues, new doulas will inevitably be supporting more breastfeeding families. Consequently, many may not be equipped with the tools to best support new parents navigate breastfeeding in the early weeks.

The listed concepts in this post will provide you, as a new or aspiring doula, with the blueprint for acquiring the necessary tools to provide quality breastfeeding support.

I've not set out in this post to tell you what specific breastfeeding knowledge you need or provide you with breastfeeding education.

On the contrary, I aim to provide you nuggets of wisdom- global or "big picture" concepts- that will help you grow as you embark on your own journey.

And yes, each one is important AF!

Learn more than what they teach you in your training

Doula training provides an excellent introduction to breastfeeding basics. By nature of the volume of content that they need to cover, however, much of your learning will need to take place once your training ends.

If I were a betting woman, I'd venture to say that most organizations cover latching- yet understanding how to help parents navigate latching challenges requires a deeper knowledge base than just the basic latching positions (cradle, cross-cradle, or football).

It requires a strong understanding of how babies latch (anatomy & physiology), what they need to latch effectively (postural stability, time to do their feeding sequence), how birth and labor practices may impact latching and feeding, and more.

More importantly, in my opinion, is building the skills to identify active & effective feeding and having the ability to clearly explain to parents what to look for so that they can be both empowered and reassured.

As helpful as it will be for you to learn more than what they teach you, it will be equally beneficial if you...

Don't learn more than you need to

In your role as a labor or postpartum doula, the things you are expected to know are pretty straight forward. Doulas provide an AMAZING first-line defense against breastfeeding challenges- they are key in providing foundational support, especially in the early weeks when breastfeeding can be the hardest- but things get hairy when folks "overlearn".

As a life-long learner, I know how offensive the idea of "overlearning" is. Yet, there is no reason for doulas (who don't have any other specific certification in breastfeeding) to learn how to navigate complex breastfeeding challenges.

When doulas start to counsel on nipple shield use, suggest pumping (or avoiding pumping) as a solution to X or Y problem, or give their opinions on supplements that they feel might be helpful, for example, it creates the potential for disaster.

The easiest way to avoid this is to refrain from learning more about complex breastfeeding issues than you need to.

It's easier to say, "This is something that is out of my skillset and an IBCLC/CBS/CLC might be more helpful" when you genuinely don't know how to navigate that problem.

Know when you need to refer

For whatever reason, knowing when to refer is something that people struggle with within LITERALLY every facet of the medical community. Both doctors and Internation Board Certified Lactation Consultants (IBCLCs) are equally likely to fail to refer as doulas and other birth workers, so this is nothing personal to doulas.

Referrals ensure that families get the appropriate level of care they need. When it comes to infant feeding, this is can be a matter of life and death.

If you're working with a family and you know they have a history of breast surgery, even before they deliver, they should be referred to an IBCLC.

If you do a postpartum visit and you learned that your client's 3-week old baby has not pooped in the past 24 hours, they should immediately be referred back to their ped.

Baby is clicking, leaking, dripping, coughing, or panting while breastfeeding? Referal. And in this case, working on latching and position fundamentals would be something you'd assist with, while still making a referral.

Do they have a rash? Referral.

Observe lipstick or creased nips? Referral.

You get the drift. I'll repeat:

Doulas provide an AMAZING first-line defense against breastfeeding challenges- they are vital in providing the foundational support, especially in the early weeks when breastfeeding can be the hardest- and providing referrals is one of the most indispensable parts of their responsibility.

Diversify where you get your breastfeeding support information

I'm going to say something that is known, yet ignored, and depending on who you ask, controversial: Most doulas are white, middle-class, straight, cis women.

Many people become doulas because of their own experiences- good or bad- and use them to formulate their business model and plan.

The same thing occurs concerning breastfeeding. So it may be hard for some doulas to understand how their experiences, in life, birth, breastfeeding, or otherwise, limit their ability to support families who fall outside of those shared experiences.

In other words, it may be hard for someone who had family come by for a month after birth, who was able to stay home for 6 months and feed on demand, and who was able to afford a tie revision to understand why someone who has to return back to work at 8 weeks, may want to pump exclusively, have their partner do half the feedings and have their baby sleep in a different room.

There is a difference between knowing families have a wide range of circumstances and desires and knowing HOW TO SUPPORT families with a wide range of circumstances and desires.

Making an active effort to diversify where you get your breastfeeding information can be a start to learning how to support families effectively.

Read material written by and for a different perspective. Converse and LISTEN to people who reached their breastfeeding goals and to those who did not to understand what factors contributed to their outcomes.

Learn and understand the cultural, social, socio-economical factors that impact breastfeeding and breastfeeding support in different areas.

Expand your breastfeeding perspective beyond one that is US-centered and become genuinely interested in breastfeeding practices and climates in other places across the world.

Arguably, the intangible aspects of breastfeeding support by doulas are the most valuable to breastfeeding success- parents can learn milk storage guidelines and latching positions from anywhere. Nowhere else besides highly skilled breastfeeding support can parents get support, validation, and encouragement in their specific circumstances to help them achieve their goals.

Counseling skills are the most potent and impactful skill you can have

Similar to the point I made above, skillful counseling is the most influential aspect of support.

Though diversifying your breastfeeding knowledge is a way to improve your counseling skills, that is but one piece of the puzzle.

It takes a surprisingly large amount of effort and time spent re-learning listening skills to master this deceptively easy concept.

We must drop the deep urge to solve their problems, ease their pain, and make things better.

This post by Lucy Riddle IBCLC presents an excellent example of the support skills I think we should strive to have and towards which I am still working.

Think of your long term goals before pursuing a breastfeeding certification.

Whew, that got emotional. No? Just me?

Switching to a more logical line of thinking, thinking long and hard about what your long terms goals are may help you as you decide which angle you want to approach breastfeeding support.

If you love birth work and you want to focus mainly on the labor and birth process, support parents in the immediate postpartum period, have no desire ever to use breastfeeding as an additional source of income, then self-learning may be all you need.

If like me, when I started out, there are no other labor or postpartum doulas in your area who have certifications in breastfeeding and you're looking to set yourself apart, then getting a certification, such as Certified Lactation Counselor (CLC) or Certified Breastfeeding Specialist (CBS) might be useful to you.

If you want to add breastfeeding support as a separate revenue stream, only want to provide breastfeeding support outside of the hospital, but not pursue an IBCLC, then maybe CBS might be the best.

If one day you want to work in a hospital, then CLC or IBCLC might be better options.

The point is before you spend money on ANY program, it's vital you sit down and think about what you want for your business, what you want for your life, how sustainable doula work alone will be for you and your family and where your passions lie.

Navigating the breastfeeding world is a bit different than the birth world, and as you're planning your business, you may wonder how breastfeeding support will fit in. Many new doulas wonder if the clients overlap (they usually don't) and what breastfeeding program is best (depends on your goals) and how adding breastfeeding support can influence their revenue (business stuff sucks huh!).

I answered these same questions to my new doula friend that I mentioned earlier after giving her these same 6 tips. I also sent her both the CLC scope and the CBS scope to help her get an idea of how the two certifications are different.

I hope that you find the information in this post as helpful as she found it.

Thanks for reading this all the way to the end!

All of those other folks who got offended by me "talking mess" or "hating" on doula organizations and didn't make it this far won't get these two cool FREEBIES you can give to your doula clients.

This Latching Guide is badass (if I do say so myself) and provides all the information parents need to get a good understanding of latching.

This Flange Sizing Guide will make understanding how to get a proper flange fit easier for both you and your clients.

If you haven't already, please follow me on facebook. And drop me a comment below about which doula org you trained with and how you liked it!