Finding the Right Level of Lactation Support: From Peer Counselors to IBCLCs

Every family’s feeding journey looks different, and so does the kind of support they need along the way. Sometimes a quick word of encouragement from another parent makes all the difference. Other times, a medical complication calls for highly specialized care. The good news is that there are many levels of breastfeeding and chestfeeding support available, each with its own strengths. All of them are valuable — there is truly “something for everyone.”

Pediatricians and Breastfeeding Education

Pediatricians are often a family’s first stop for newborn care, but formal training in breastfeeding is limited in most medical schools and residency programs. Estimates suggest that many pediatricians receive only a few hours of lactation education during their entire training. This means they are skilled in monitoring infant health, growth, and development — but they may not always have the in-depth expertise to troubleshoot complex feeding challenges.

That said, pediatricians play a critical role. They are the ones checking weight gain, ruling out underlying medical issues, and referring families when more specialized feeding support is needed.

What about “Breastfeeding Medicine” doctors?

Some pediatricians (and occasionally family medicine doctors) go a step further and pursue certification through the Academy of Breastfeeding Medicine or complete a fellowship in Breastfeeding and Lactation Medicine. These physicians have advanced training specifically in lactation and can manage more complex medical cases related to breastfeeding — things like maternal endocrine disorders, recurrent mastitis, tongue tie evaluation, or babies with significant feeding difficulties.

Peer Counselors and Volunteer Support

For many families, the first line of help comes from peer counselors or volunteers.

• La Leche League Leaders and Breastfeeding USA Counselors are trained volunteers who have personal breastfeeding experience and receive structured education to guide and encourage parents.

• They provide emotional support, reassurance, and basic problem-solving, such as positioning tips, ideas for pumping, or helping parents understand what’s normal in the early days.

• They do not provide medical care, but they are often accessible, free, and community-based.

Certified Lactation Counselors (CLCs)

Certified Lactation Counselors are professionals who complete a 45-hour course followed by a certification exam through the Academy of Lactation Policy and Practice (ALPP).

• Their training covers breastfeeding management, counseling techniques, and common early challenges.

• CLCs are well-equipped to support healthy parents and babies with routine lactation needs, such as latch basics, positioning, building supply, and navigating return to work.

• They are not required to have a healthcare background and typically refer families to higher-level providers for complex cases.

International Board Certified Lactation Consultants (IBCLCs)

IBCLCs are the gold standard in lactation care. Becoming an IBCLC requires hundreds of hours of clinical experience, completion of specific health sciences education, and passing a rigorous international exam. Many IBCLCs are also nurses, midwives, or other health professionals, but some come from other backgrounds in maternal-child health.

Scope of Practice

IBCLCs are uniquely trained to:

• Assess and manage complex feeding issues, such as tongue tie, low milk supply, oversupply, nipple pain, mastitis, or infants with medical complications.

• Develop individualized feeding plans that take into account both the parent’s health and the baby’s needs.

• Provide guidance on pumping, milk storage, and feeding equipment.

• Collaborate with pediatricians, OB/GYNs, speech therapists, and other providers to ensure a baby’s feeding plan supports overall health.

• Support lactation across many situations — after C-section, in the NICU, with multiples, or with induced lactation/adoptive feeding.

IBCLCs are also bound by a professional code of ethics and must complete ongoing continuing education to stay certified.

Pulling It All Together

Every level of lactation support matters.

• A peer counselor’s encouragement at 2 a.m. can keep a parent going through those tough first nights.

• A CLC can give practical tools for positioning and pumping.

• An IBCLC can dig deep into the science and clinical care needed when challenges go beyond the basics.

• Pediatricians (especially those with advanced breastfeeding medicine training) are critical in ensuring that feeding is safe and medically sound.

No matter which path families take, the important thing is that support exists at many levels — and all of it is worth celebrating.

✨ At Lindsey Lactation, I’m proud to be an IBCLC and to collaborate with pediatricians, counselors, and community supports. Whether you’re looking for reassurance, education, or advanced problem-solving, there’s a place for you here.