Differences in the provision of lactation consulting based on the type of education of lactation consultants

Czech version

Authors: A. Švestková ¹; Ľ. Matulníková ¹; Hynek Heřman ²; L. Vrlová ¹
Authors‘ workplace: Fakulta zdravotnických věd, UP v Olomouci2 Ústav pro péči o matku a dítě, Praha ¹
Published in: Ceska Gynekol 2026; 91(3): 186-192
Category: Original Article
doi: https://doi.org/10.48095/cccg2026186

Overview

Introduction: Lactation consulting plays a key role in supporting breastfeeding. The quality of recommendations may influence both the duration and exclusivity of breastfeeding, which is defined as the provision of breast milk only, without additional fluids or foods, except for medications, vitamins, or oral rehydration solution. In the Czech Republic, lactation consultants include those with healthcare education and those without one who have completed specialized training courses. Differences in care approaches may exist between these groups. Objective: To compare the recommendations provided by lactation consultants with and without healthcare education and determine whether they differ significantly. Methods: A quantitative survey was conducted using an online questionnaire completed by 460 breastfeeding women from the Czech Republic and Slovakia. Respondents had consulted either lactation consultants with healthcare education (N = 241, professional lactation consultants) or those without such an education who had completed a specialized course (N = 219, non-professional lactation consultants). Data were analyzed using the chi-square test (P < 0.05). Results: Significant differences were found between the groups (P < 0.001). Professional consultants more frequently recommended breastfeeding on demand, alternative supplementation methods, and were more cautious in recommending aids. Non-professional consultants more often recommended bottle feeding and fixed breastfeeding intervals. Conclusion: Results indicate a difference in the level of expertise between the groups and confirm the importance of professional education in the field of lactation consulting. The study supports the need for unified care standards and an emphasis on evidence-based recommendations.

Keywords:

breastfeeding – lactation – counseling – patient education as a topic – health education – professional role

Sources

1. Dennis CL, Shiri R, Brown HK et al. Breastfeeding rates in immigrant and non-immigrant women: A systematic review and meta-analysis. Matern Child Nutr 2019; 15 (1): e12809. doi: 10.1111/mcn.12809.

2. World Health Organization. Světový týden kojení 2024: Kojení jako základ zdraví a rovnosti. WHO Country Office Czech Republic 2024. [online]. Available from: https: //www.who.cz/wp-content/uploads/2024/08/Svetovy-tyden-kojeni-2024.pdf.

3. Suárez-Cotelo MC, Movilla-Fernández MJ, Pita-García P et al. Breastfeeding knowledge and relation to prevalence. Rev Esc Enferm USP 2019; 53: e03433. doi: 10.1590/S1980-220X 2018004503433.

4. Dodgson JE. Lactation-specific certifications: a comparison of independently accredited credentials. J Hum Lact 2020; 36 (1): 119–125. doi: 10.1177/0890334419888217.

5. Eden AR. An oral history interview with Leon Gross, PhD. J Hum Lact 2019; 35 (3): 408–412. doi: 10.1177/0890334419844987.

6. Eden AR. Jan Riordan: an oral history. J Hum Lact 2019; 35 (3): 413–417. doi: 10.1177/089033 4419830993.

7. Hoover CM, Tarrant M, Dodgson JE et al. The Journal of Human Lactation: a historical analysis. J Hum Lact 2019; 35 (4): 750–758. doi: 10.1177/0890334419869582.

8. Eden AR. Breastfeeding support: from informal care work to professional health-care work. Anthropol Work Rev 2017; 38 (1): 28–39. doi: 10.1111/awr.12110.

9. Fan WQ, Chan C, Paterson S et al. Weekly proactive telephone breastfeeding standard care by lactation consultants in the first month postpartum prolongs breastfeeding for up to 6 months. Nutrients 2023; 15 (9): 2075. doi: 10.3390/nu15092075.

10. Jerin I, Akter M, Talukder K et al. Mobile phone support to sustain exclusive breastfeeding in the community after hospital delivery and counseling: a quasi-experimental study. Int Breastfeed J 2020; 15 (1): 14. doi: 10.1186/s13006-020-00258-z.

11. Haase B, Brennan E, Wagner C. Effectiveness of the IBCLC: Have we made an impact on the care of breastfeeding families over the past decade? J Hum Lact 2019; 35 (3): 441–452. doi: 10.1177/0890334419851805.

12. Marmet C, Dodgson JE. The birth and development of the lactation consultant profession (1980–2007): an interview with Chele Marmet (Part II). J Hum Lact 2024; 40 (2): 200–207. doi: 10.1177/08903344241235169.

13. International Board of Lactation Consultant Examiners. Step 1: Prepare for IBCLC Certification. [online]. Available from: https: //ib-clc-commission.org/step-1-prepare-for-ibclc-certification/.

14. Rhodes EC, Damio G, LaPlant HW et al. Promoting equity in breastfeeding through peer counseling: the US Breastfeeding Heritage and Pride program. Int J Equity Health 2021; 20 (1): 128. doi: 10.1186/s12939-021-01408-3.

15. Kellams A, Harrel C, Omage S et al. ABM Clinical Protocol #3: supplementary feedings in the healthy term breastfed neonate, revised 2017. Breastfeed Med 2017; 12 (3): 188–198. doi: 10.1089/bfm.2017.29038.

16. World Health Organization. Infant and young child feeding [online]. Available from: https: //www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding.

17. Berens P, Brodribb W. ABM Clinical Protocol #20: engorgement, revised 2016. Breastfeed Med 2016; 11 (4): 159–163. doi: 10. 1089/bfm.2016.29008.pjb.

18. La Leche League Canada. Breast Engorgement. [online]. Available from: https: //www.lllc.ca/breast-engorgement.

19. Kilci Erciyas S, Kavlak O. The effect of back and breast massage on the amount of milk and anxiety level of mothers with preterm birth: a randomized controlled study. J Neonatal Nurs 2024; 30 : 251–257. doi: 10.1016/j.jnn.2023.10.003.

20. Munsittikul N, Tantaobharse S, Siripattanapipong P et al. Integrated breast massage versus traditional breast massage for treatment of plugged milk duct in lactating women: a randomized controlled trial. Int Breastfeed J 2022; 17 (1): 43. doi: 10.1186/s13006-022-00485-6.

21. Holmes AV, McLeod AY, Bunik M. ABM Clinical Protocol #5: peripartum breastfeeding management for the healthy mother and infant at term, revised 2013. Breastfeed Med 2013; 8 (6): 469–473. doi: 10.1089/bfm.2013.9979.

22. Centers for Disease Control and Prevention. Maternal Diet. U.S. Department of Health & Human Services. [online]. Available from: https: //www.cdc.gov/breastfeeding-special-circumstances/hcp/diet-micronutrients/maternal-diet.html.

23. Hernández-Aguilar MT, Bartick M, Schreck P et al. ABM Clinical Protocol #7: model maternity policy supportive of breastfeeding. Breastfeed Med 2018; 13 (9): 559–574. doi: 10. 1089/bfm.2018.29110.mha.

24. Hermanson Å, Åstrand LL. The effects of early pacifier use on breastfeeding: a randomised controlled trial. Women Birth 2020; 33 (5): e473–e482. doi: 10.1016/j.wombi.2019.10.001.

25. Coentro VS, Perrella SL, Lai CT et al. Impact of nipple shield use on milk transfer and maternal nipple pain. Breastfeed Med 2021; 16 (3): 222–229. doi: 10.1089/bfm.2020.0110.

26. LeFort Y, Evans A, Livingstone V et al. Academy of breastfeeding medicine position statement on ankyloglossia in breastfeeding dyads. Breastfeed Med 2021; 16 (4): 278–281. doi: 10.1089/bfm.2021.29179.ylf.

27. Thomas J, Bunik M, Holmes A et al. Identification and management of ankyloglossia and its effect on breastfeeding in infants: clinical report. Pediatrics 2024; 154 (2): e2024067605. doi: 10.1542/peds.2024-067605.

28. Brodribb W. ABM Clinical Protocol #9: use of galactogogues in initiating or augmenting maternal milk production, second revision 2018. Breastfeed Med 2018; 13 (5): 307–314. doi: 10.1089/bfm.2018.29092.wjb.

29. O‘Shea JE, Foster JP, O’Donnell CP et al. Frenotomy for tongue‐tie in newborn infants. Cochrane Database Syst Rev 2017; 3 (3): CD011065. doi: 10.1002/14651858.CD011065.pub2.

30. Bookhart LH, Anstey EH, Kramer MR et al. A nation-wide study on the common reasons for infant formula supplementation among healthy, term, breastfed infants in US hospitals. Matern Child Nutr 2022; 18 (2): e13294. doi: 10.1111/mcn.13294.

31. World Health Organization. Breastfeeding for mothers and babies who are unable to breastfeed. [online]. Available from: https: //www.who.int/tools/elena/interventions/breastfeeding-inability.

32. Campbell SH, Bernardes N, Tharmaratnam T et al. Effectiveness of interprofessional development of foundational lactation open education resources. Clin Simul Nurs 2024; 95 : 101603. doi: 10.1016/j.ecns.2024.101603.

33. Rodríguez-Gallego I, Corrales-Gutierrez I, Gomez-Baya D et al. Effectiveness of a postpartum breastfeeding support group intervention in promoting exclusive breastfeeding and perceived self-efficacy: a multicentre randomized clinical trial. Nutrients 2024; 16 (7): 988. doi: 10.3390/nu16070988.

34. DeCoste KL, Benoit BL, Dewart GK et al. Registered nurse lactation consultants’ experiences supporting maternal mental health: a qualitative descriptive study. Midwifery 2024; 138 : 104145. doi: 10.1016/j.midw.2024.104145.