Rachel O'Brien IBCLC Lactation Consultant

I struggled like hell breastfeeding my first child. For the first 6 weeks of her life, I would cringe and often cry each time she would latch. I had very little support and didn’t know where I should go to get it. In retrospect, I should have reached out to my doula; if she couldn’t help me, I am sure she knew someone who could. But, in my sleep-deprived state with crazy hormonal changes and also being absolutely head-over-heels infatuated with my baby, I didn’t reach out. I thought I had to “toughen up,” and I guess I kinda did because we stuck with it for 13 months. It actually wasn’t until the birth of my second daughter that I realized what breastfeeding should feel like when it is going right and felt like if only I could turn back time, I would have asked for the help I needed. Rachel O’Brien, IBCLC joins this blog post to answer some questions about finding and using lactation support.

A bit about Rachel

Rachel is an internationally board certified lactation consultant and also holds a masters degree in human lactation (holy, cow! I didn’t even know that advanced degree existed; how cool is that?). Not only is Rachel proficient in all things lactation-related (latch issues, nipple pain, pumping, safe sleep, safe medications, etc.), her practice is also super-LGBTQI+ friendly & experienced and has worked with straight, lesbian, gay, queer, poly, and trans families. She has worked with adoptive breastfeeding and chestfeeding, re-lactation and induced lactation, nursing after breast reduction/augmentation, and more. So, long story short, she is a great resource for our community and I am so happy that she agreed to answer some common questions!

Q: For those that aren’t familiar with the different types of lactation consultants and counselors, can you explain what an IBCLC does and how they are different from other LCs? Why would someone want to see an IBCLC before an issue arises?

A: To become an IBCLC you need to take 14 college-level health science classes, at least 90 hours of lactation-specific education, and complete 300-1,000 hours of clinical experience in lactation! Then, and only then, can you sit for the international exam that is only given twice per year. There are many other lactation certifications in the United States, and all of them have a different scope of practice- and to complicate things even further, anyone can call themselves a “lactation consultant” even with absolutely no training.

An IBCLC knows how to handle normal breastfeeding situations (like cluster feeding, sore latch, pumping education) as well as complex clinical situations that can arise (like low milk supply due to health issues in the lactating parent, oral restrictions in baby like tongue tie & lip tie, breastfeeding babies with cleft palate or other complex feeding issues).

It is important to get help early because many breastfeeding problems are like a snowball rolling down a hill- they start small but can grow and get out of control fast!

Q: Realizing that no two visits are the same, could you briefly describe the course of a standard visit?

A: Usually my home visits are two hours long. I sit and talk to the parent(s) first and take a detailed health history. I then weigh the baby and help the parent with a feeding. At the end of the feed, I weigh baby again to get a snapshot of the milk transfer. The parent gets a 48-hour care plan from me, customized to their needs and their situation. I send a detailed report to the baby’s pediatrician or medical provider and to the parent. The parent also gets unlimited phone, email & text follow up from me for two weeks.

Q: Who else should people seek help from in addition to an IBCLC if they are having breastfeeding difficulties?

A: Support groups are wonderful when you’re breastfeeding- it’s such a comfort to be around other people feeding their babies, and to know that you’re not alone. I run a weekly support group in Sudbury, MA where families can weigh their babies, have a snack, and make friends!

Q: What is your personal style and/ or approach in your counseling people learning to or struggling with breastfeeding? What should people keep in mind when finding an IBCLC to support them in their journey?

A: We are lucky to live in a part of the country that has quite a few private practice IBCLCs who do home visits. It’s really important that you choose an IBCLC whose personality clicks with yours! Some of us are earthy-crunchy, some of us are more medicalized, we all have different areas of specific expertise and interest. Some of us are warm and fuzzy and some of us are no-nonsense.. some are laid back, some are go-getters. You can get a great idea about an IBCLC’s personality and style by checking their website or emailing or calling them before you book a visit.

I work very hard to give my clients guilt-free support with lots of humor and empathy. I meet parents where they are (literally and figuratively) and help them to reach *their* lactation goals. I also work as an IBCLC on the maternity floor at UMASS Memorial in Worcester; this means I have a really well-rounded understanding of how things work in those first couple of days (if you birthed in the hospital) and how that can affect nursing once you get home.

Fair warning- if you work with me, you’ll get lots of handouts. I love handouts. And I might say “boob” a few times during our visit.

Q: What is the best way for people to connect with you or with other IBCLCs that service their area?

A: The best way to reach me is usually to email or text ((413) 687-0106), as I always have my ringer off out of respect for my home visit clients. If you’d like to see the different IBCLCs in your area go to zipmilk.org, enter your zipcode, and browse through the IBCLC profiles.

Q: Is there anything else you would like parents to know about chest/breast feeding or about working with an IBCLC?

Breastfeeding rates in Massachusetts are the highest they’ve been in recorded history, but we have lost entire generations of breastfeeding knowledge. Many of the families I work with have never seen a baby breastfeeding before their child was born- why do we expect you to know how to do something you’ve never even *seen* before? If breastfeeding was always easy I wouldn’t have a job. There is NO shame in asking for help.

Also- the majority of health insurance companies in MA will reimburse you for an IBCLC home visit, and Aetna even covers 6+ home visits with no co-pay or deductible.


To learn more about Rachel, visit her website  website and follow her on Facebook . Also, stay tuned on the Birthing Matters Doula Services blog for more provider spotlights!

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