I’m a Soon-to-Be Lactation Consultant and I Don’t Care What You Do with Your Boobs

The story is that a lactivist will grab your breast-that-is-of-course-best and ram it into your new baby’s mouth, regardless of your preferences, feelings, or mental health.
Publish date:
July 15, 2015

Editor's Note: A previous headline on this piece referred to the author as a "Lactation Consultant." This was a mistake on the editor's part. The author is not yet certified and didn't claim to be in her original headline.

This summer, I’m taking the expensive and rigorous exam that, should I pass, will allow me to call myself an International Board Certified Lactation Consultant (IBCLC).

IBCLCs, or lactation consultants, help people breastfeed or express/pump breast milk, offer guidance and information about all things related to feeding babies, and troubleshoot problems related to breastfeeding.

Although lactation is one of the most basic functions of the human body, it can be far from easy. That’s where people like me step in.

Folks of my sort have been given all sorts of names. We have our professional titles, and then we have some less-than-flattering names: Lactivists. The Breastapo. Boob Nazis. Nipple Nazis. Breastfeeding police. Breastfeeding propagandists. “Mammary mafia” is one that I learned recently.

I have to give people credit for creativity, because the names keep coming. I’ve reclaimed the label “lactivist” much as Inga Muscio encouraged me to reclaim the word “cunt” when I read her book half a lifetime ago; this word is simply a contraction of “lactation” and “activist,” and it fits.

The rest of those labels sound a little, well, Godwin-y, don’t they? I’m going to go out on a limb and say that it’s not the lactivists like me who are solely responsible for perpetuating the Mommy Wars, since we can’t even come up with good insults.

You might not believe in our positive intent if you’ve read a mainstream news article about breastfeeding in recent years.

The story, as these articles tell it, is that a lactivist will grab your breast-that-is-of-course-best and ram it into your new baby’s mouth. She (or he) will not care about your feelings, your history, your medications, your mental health, your preferences, or anything but getting your innocent baby to latch onto The Holy Boob.

Those gangsters of galactopoiesis* (ooh, I came up with a new one!) will stop at nothing—nothing!—to get you to breastfeed, and then when you cannot do it, they will yell at you and say you are poisoning your baby.

They add that, for the record, [insert celebrity or very smart person name here] was fed formula and he/she is fine, and neither poisoned nor dead, unless this person is dead of old age, in which case that is held up as proof that breastfeeding will not stop you from dying of old age, so whether you do it or not is obviously not a big deal.

But here’s something that you won’t hear in these articles, and it might shock you: I don’t care what you do with your boobs, unless you want me to care about them.

I’m not going to try to convince you to breastfeed, or manhandle your chest without your consent.

What I do care about, as a fellow human being as well as a lactation professional, is that you get to use your boobs how you want to use them. You might want to breastfeed. You might not. You might want only to pump, or to use formula sometimes (this is called “mixed feeding”). It’s not my job to tell you what to do—it’s my job to help you reach your breastfeeding goals.

“Breastfeeding goals” is a technical term we use to describe whether a person cares about making milk with one’s boobs and for how long. This phrase is repeated often in the clinical competencies of an IBCLC. There’s a good reason for that—it’s the most important component of quality breastfeeding support.

If a lactation professional is not supporting your breastfeeding goals, she or he is not doing her or his job. Period.

I’ll grant you that not every lactation professional is good at the job, and we all have bad days. There are brilliant physicians with shitty bedside manner. There are baristas who are extremely pleasant and make horrible coffee. The people who we tend to look up to as experts in the lactation field are not only well loved by fellow professionals, but by the families they serve, and we can only hope that fledgling lactation consultants are following in their footsteps to offer evidence-based and compassionate care to families.

I’m not going to tell you that “The Mommy Wars don’t exist” and “There is never anyone who has said mean things about people using formula,” because we all know that’s untrue.

However, I think we can come to a place of understanding, and agree that not all lactation professionals are acting unprofessionally, and that not all people really care all that much about what your baby is being fed as long as your baby is being fed. You’re not being constantly judged—unless, if you’re anything like me, you're constantly judging yourself.

Here’s what I do when I am helping someone breastfeed: I ask how things are going (and not just how breastfeeding is going). I ask what things need to change. I ask about anything I feel is relevant and think critically about the situation to try to come up with a plan that involves feeding the baby appropriately and protecting (or, sometimes, decreasing) the milk supply in a way that everyone can be happy with and that is sustainable. I offer encouragement and understanding.

Here is what I do not do: chase down people who are not breastfeeding and ask why; tell women they need to breastfeed their babies at any cost; or slaughter people because of their infant feeding choices. I have only had someone’s kneecaps broken once. (That’s a joke.)

Not breastfeeding when you wanted to sucks. That’s what any breastfeeding supporter understands and is trying to prevent. So we help.

Sometimes when we help it still doesn’t work out for some reason, and we wonder what we could have done better or differently. We wonder where we went wrong. Sometimes our wondering is answered by a refrain of, “Breastfeeding doesn’t matter anyway.”

Here’s another trade secret: Breastfeeding does matter to a whole lot of people. That’s why we hear their stories, because breastfeeding mattered, and when it didn’t go well, that hurt. How we feed our babies obviously matters if there’s so much passion and division, but wouldn’t it be nicer if there were fewer hurt feelings to go with it? When we feel empowered and supported, we hurt less.

While not everyone wants to breastfeed, according to the CDC, about 79% of babies in the United States start out breastfeeding. By six months, less than 20% of babies are exclusively breastfed, and at least some of those parents feel like they “failed” at breastfeeding.

My goal as a lactation professional is less about getting people to breastfeed—after all, most people start—and more about helping you reach your own breastfeeding goals. What do I care about the most? I care about you not feeling like you failed.

*Galactopoiesis is the fancy word for the formation and secretion of milk.