IBCLC meets Midwife?

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Hello! I am currently an RN and have been for 5 years. I have done the basic nurse work; med surg, outpatient infusions, blah blah blah, and now I'm a school nurse. LOVE being a school nurse! The problem is that I've developed this passion for lactation and I just can't shake it. I've become very involved with my local La Leche League and am currently pursuing my accreditation to be a leader. I've spent hours researching the IBCLC website and I am pretty confident that I want to sit for the board exam to become a certified lactation consultant.

My question is....how closely do Midwives work with lactation consultants? Is there a need for such after a home or birthing center birth? I've worked in the hospital setting and it isn't for me. I want to be able to help moms the best way that I can and I feel that is best done outside of the hospital setting. I have this plan...or idea....to work with a Midwife or birthing center and offer mothers postpartum lactation care via home or office visit. Does anyone have any opinion, suggestion or insight on this topic? I would honestly love to pick a Midwife's brain if at all possible.

Thanks!

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On 6/11/2019 at 3:50 PM, boymomnurse said:

Hello! I am currently an RN and have been for 5 years. I have done the basic nurse work; med surg, outpatient infusions, blah blah blah, and now I'm a school nurse. LOVE being a school nurse! The problem is that I've developed this passion for lactation and I just can't shake it. I've become very involved with my local La Leche League and am currently pursuing my accreditation to be a leader. I've spent hours researching the IBCLC website and I am pretty confident that I want to sit for the board exam to become a certified lactation consultant.

My question is....how closely do Midwives work with lactation consultants? Is there a need for such after a home or birthing center birth? I've worked in the hospital setting and it isn't for me. I want to be able to help moms the best way that I can and I feel that is best done outside of the hospital setting. I have this plan...or idea....to work with a Midwife or birthing center and offer mothers postpartum lactation care via home or office visit. Does anyone have any opinion, suggestion or insight on this topic? I would honestly love to pick a Midwife's brain if at all possible.

Thanks!

From what I know in NYC, independent midwives or freestanding birth centers do not have the money to hire IBCLCs. I know a few home birth midwives who do the visits themselves and are also IBCLCs so they just do the breastfeeding support on their first home visit after the birth when completely other necessary tasks. You may be able to team up with home birth midwives or a birth center where you are. Don’t mean to discourage you, just my experience in NY.

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Specializes in OB.

Yes, I am a CNM at a freestanding birth center and we do not currently have an IBCLC on staff. We *need* one, and in a perfect world we would be able to fold the cost of lactation services into our global cost of care for our clients and offer it free as part of their fees, but alas, insurance doesn't currently work like that. We do have a few in the community that we refer to the most frequently. The one we refer to the most has been able to recently start getting some insurance reimbursement, but it's still such a long process with fairly small reimbursements that she charges her fee to the client up front and then has them bill their insurance on their own.

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I’ve heard that because I’m also an RN, insurance reimbursement would be easier. Have you heard that?

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Specializes in OB.
3 hours ago, boymomnurse said:

I’ve heard that because I’m also an RN, insurance reimbursement would be easier. Have you heard that?

I haven't, but I'm not very well versed in the topic. It probably varies state by state as well.

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Specializes in Nurse Leader specializing in Labor & Delivery.
On 9/7/2019 at 8:21 AM, boymomnurse said:

I’ve heard that because I’m also an RN, insurance reimbursement would be easier. Have you heard that?

No. It's extremely challenging to get paid for lactation consults. Typically as a private practice IBCLC, the patients themselves have to pay you up front and then submit for reimbursement themselves.

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I can't speak to the hospital/birth center side but, as a mom, I paid out-of-pocket for a lactation consultant then submitted a receipt for reimbursement with my insurance. The hospital recommended a couple of consultants in the community and I also learned of consultants through word-of-mouth recommendations. If you're a school nurse then you already know LOTS of moms! If you're good at what you do, word-of-mouth will be your best advertisement. The lactation consultant I chose came to my home -- that was key for me. She brought a hospital-grade pump and the paperwork to have the pump covered by insurance, which made that easy. And she was kind, encouraging, and non-judgemental ?

If you have a passion for this, I say go for it! You could have a really positive impact on moms and families (in addition to what you do now!) and sounds like you'll enjoy the work.

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The lactation consultants I know are self employed and not affiliated with any hospitals or birth centers. The pediatrician's office where my kids go has two on staff and moms can all and make appointments to come in and see them. When my DS was born, we had a great local place for new moms that had lactation consultants, new mom classes, etc. It has since closed. My DD was born in Washington, DC and we used the Breastfeeding Center : http://breastfeedingcenter.org/ . Maybe there is a place like this where you live?

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There are actually a number of birth centers that employ lactation consultants (IBCLCs). They tend to be the larger birth centers. For example, Women's Birth and Wellness Center in Chapel Hill, NC, and the Midwife Center for Birth and Women's Health in Pittsburgh, PA.

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Specializes in Labor & Delivery, Mother/Baby, NICU.
On 6/11/2019 at 12:50 PM, boymomnurse said:

My question is....how closely do Midwives work with lactation consultants? Is there a need for such after a home or birthing center birth? I've worked in the hospital setting and it isn't for me. I want to be able to help moms the best way that I can and I feel that is best done outside of the hospital setting. I have this plan...or idea....to work with a Midwife or birthing center and offer mothers postpartum lactation care via home or office visit. Does anyone have any opinion, suggestion or insight on this topic? I would honestly love to pick a Midwife's brain if at all possible.

Hello there! I will soon become an IBCLC and I have several friends who are midwives. Hopefully I can provide some insight for you. 

Midwives work very closely with IBCLCs and some midwives also hold the certification. There is a definitely a big need for lactation support in the home and birth center setting. There are opportunities out there for you to work with midwives in a birth center. I would start reaching out to your local birth centers and midwives to make some connections, ask questions, etc. It is an excellent idea to either work in conjunction with a birth center as a private practice or work at a birth center. As far as payment goes, it is my understanding that receiving payment can be tricky but definitely doable. Your clients can pay you outright or you can file for your NPI so you can bill insurance. 

If you haven't heard of this website already, www.paperlesslactation.com is a great resource. I hope this information is helpful. Please feel free to reach out if you have any further questions.

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