Tag: Infant reflexes

2 Very Simple, Very Powerful Documents

On By Suzanne Sanders, IBCLCIn Tools of the tradeLeave a comment

I read these two, very short, bullet-pointed documents and learned what I need to adjust when I work with patients. It was very simple and very powerful. When I picked up these documents I thought: dull, boring, dull but necessary. I was wrong. They’re actually very informative: the Clinical Competencies and the Scope of Practice.

Did you know the Clinical Competencies basically lays out what your lactation consultation should include? I mean, not in those exact words, but kind of. If you are in private practice, or have free reign in your consultations to use whatever format you choose, take a look at section III to make sure you are covering the bases in your visits.

And, maybe I’m the only one who has thought this, but when it comes to maternal nutrition while breastfeeding, I’ve wondered, ‘is it within my scope of practice to discuss this, or do I need to punt them off to a registered dietitian?’ (I practice in the US). Turns out “Provide evidence-based information regarding lactation and foods, including their potential impact on milk production and child safety” is in the Clinical Competencies (Section III Develop, Implement and Evaluate an Individualised Feeding Plan in Consultation with the Client 4.)

Which means I have to stay educated and keep abreast of evidence based nutrition guidance for lactating women.

I’m going to assume, someone correct me if I’m wrong, that as long as A) I’m staying educated and keeping up to date with nutrition guidelines; and B) I have a clear understanding of when I should refer to a registered dietitian; then I need to incorporate maternal nutrition into my visits with patients. (After this long maternity leave)

When might be a time for me to refer to a registered dietitian?

  • Maybe if … there is a mom who has a history of disordered eating and whose child is diagnosed with Cows Milk Protein Allergy (she needs to cut dairy from her diet temporarily while breastfeeding)
  • Maybe if … I have a mom who has low supply and is not eating enough calories. I would probably give her advice once, follow up and if she is still not eating enough then send her to a registered dietitian

So. Nutrition is included in my scope of practice. Got it.

Guess what else is included…

In my blog post Tips and techniques I picked up while observing a lactation consultant: Lactation Station and more (https://forlactationprofessionals.com/2025/10/10/tips-and-techniques-i-picked-up-while-observing-a-lactation-consultant-lactation-station-and-more/ ) I admit that I rarely thoroughly assessed infant reflexes, just the basics like the gag reflex. Assessing reflexes of the infant is in the Clinical Competencies (See section III. Skills to Assist Breastfeeding Dyad 3.). That’s an oversight on my part. And that, my friends, is exactly why I am doing this blog and podcast. To go from a good lactation consultant to an extraordinary lactation consultant. An extraordinary LC assesses infant reflexes. Lesson learned. Now I have to educate myself on infant reflexes so that I can competently include them in my future exams. Stay tuned for a post about reflexes down the road.

These documents certainly help to give me clarity on exactly what is in my scope of practice.

I think one reason I tend to second guess myself is that I have worked in both a pediatric clinic and a hospital, where I have worked very closely with physicians, physical therapists, and speech therapists. Not wanting to step on any toes, I found myself asking frequently, is this within my scope of practice? I think this has led to appropriate restraint in some areas, and also too much timidity in other areas. See above. While I did thoroughly assess these documents back when I was initially training to become an IBCLC, I never really thought to look at them again. I now recognize that I need to review these documents more often. Perhaps yearly? And, certainly anytime I ask the question: is this in my scope of practice?

Now… go glance at these 9 pages of documents, it’s quick and easy and bullet pointed. You’ll find both documents under the heading IBCLC Professional Standards here https://iblce.org/about-iblce/bylaws-iblce-documents/

Just to pique your interest, I’m going to include a few bullet points from the documents:

  • Assess social support and possible challenges. (Clinical Competencies III History Taking and Assessment Skills 11.)
  • Support the client to make evidence-based decisions for themselves and their child(ren). (Clinical competencies III Develop, Implement and Evaluate an Individualised Feeding Plan in Consultation with the Client 12.)
  • Providing evidence-based information regarding complementary and alternative therapies during lactation and their impact on milk production and the effect on the child. (Scope of practice III 5.)
  • Assess the child’s growth using World Health Organization Child Growth Standards. (Clinical Competencies III Skills to Assist a Breastfeeding Dyad 24.) See my post all about the WHO Growth Chart. https://forlactationprofessionals.com/2025/06/01/who-growth-chart/

Are there areas in your practice that you are missing? Are there areas in your practice that are outside of your scope?

Suzanne Sanders, IBCLC

Resources

Listen to this podcast episode

Listen on Apple Podcasts
Listen on Spotify
Listen on Overcast

Tips and techniques I picked up while observing a lactation consultant: Lactation Station and more

On By Suzanne Sanders, IBCLCIn Shadowing a Lactation Professional: Building My Clinical Toolkit1 Comment

The purpose: To collect techniques, verbiage and tips from an IBCLC that I can emulate with my own patients in the future.

The mission: I spent a day shadowing IBCLC, Sarah Glenn at her private practice, Lactation Station and more in Summerville, South Carolina.

The results: Walking into Sarah’s office my eyes linger on the large painting that faces the one cozy recliner in her room. The focus of the portrait is five or so women and one man lounging outdoors in a beautiful landscape. One of the women is nursing a newborn, one woman is pumping, still another is nursing a toddler who is standing on a stone to reach the breast, the man is baby wearing with a bottle in his hand, another woman is offering her baby a bottle, and another is nursing multiples. It is a beautiful depiction of the many different ways parents can feed littles. It sends a clear message: there are many ways to feed your little one, and every way is beautiful. Sarah reinforces this message all through out the day as she encourages and guides moms as they follow the feeding journey that works best for their family.

Sarah has a wide range of services to offer her patients at her practice, you can read all about those on her website LactationStationandMore.com. The unique components of her practice that piqued my interest were Walk-In Wednesday and therapeutic ultrasound. And so, I spent a day with her on a Wednesday to see the ‘Walk – ins’ in action. In each section below you’ll find the notes and techniques I took away during my day spent in her office. I observed multiple different appointments, some previously scheduled full visits while others were brief walk-ins.

Quotes

I overheard these phrases through out the day while observing a variety of lactation consultations. Her support of the family unit was obvious, you’ll get a feel for this as you read the quotes I took directly from Sarah:

“I understand what you’re saying.”

“This is a safe space, you can say anything, do anything, rant or rave.”

“What can we do to make that a little bit easier for you?” This question came after discussing the supply and demand dynamic of breastmilk production. This mom had been exclusively pumping 1-3 times a day and wished to increase her supply and start latching. Sarah recommended more breast stimulation.

“In a perfect world, pretend you’re not having any problems, what do you want [feedings] to look like?”

“It sounds like mental health right now is our primary focus… your mental health is more important to me right now than any of this.” Stated after an in depth conversation about mom’s mental health history and her current symptoms of anxiety and depression.

“What if she only had half a sandwich, and an hour later she wants the other half? I do that sometimes.” Stated while Sarah was encouraging on-demand nursing.

Walk-In Wednesday:

Let’s talk about Walk-In Wednesday. She charges $25 per 15 minutes and no appointment is required, new patients and returning patients can just drop in while she is in the office from 9 am to 2 pm on Wednesdays. Upon arrival, she explains the pricing structure to the patients, she typically does not run these specific visits through insurance. She then jumps straight to “What’s your main question for today?” I saw a mom drop in for therapeutic ultrasound and one parent drop in who was concerned her baby had a lip tie. Sarah offers this service as a convenience for her patients because she is ‘in the office anyways’, and she does typically have 1-2 appointments scheduled during that time period. Walk-In Wednesday will occasionally turn drop-in patients to full blown future appointments; but, it is more likely that they will come back for her free weekly Mom Circle. The walk-ins are not a driving force of income, it is really just an additional way that Sarah cares for the parents in her community.

Infant Reflexes:

During some appointments, I noticed Sarah assessing infant reflexes. Honestly, that is not something I have focused much on in the past, except for maybe the gag reflex. She learned more about this after attending a Master Class with Jennifer Tow about Intuitive Parenting. Sarah utilizes infant reflexes in her assessment to help determine what next steps may be needed for a baby who is having difficulties. Are all of the reflexes firing appropriately? If so, we may just just need to focus on positioning and latching and we will see improvement. If the reflexes are not all firing appropriately, it is possible that baby may need some additional support or referrals or body work, before seeing improvement.

Therapeutic Ultrasound for breast inflammation

She offers this at her practice: see this blog post to read more.

Props Used During Lactation Appointments

  • Nursing necklace: Sarah showed this to a mom who had a 10 week old. She recommends long necklaces that the parent can wear while the baby nurses that are made of silicone or wood, as it usually ends up in baby’s mouth. These can help prevent twiddling and maybe even help with distracted nursing.
  • Baby doll: After helping baby get latched (for the first time in weeks! Insert huge tearful, smiley face from mom) and while baby was settled and nursing, Sarah used the baby doll to demonstrate latching and positioning techniques that mom can replicate.
  • Picture hanging on wall that gives a visual of neuroendocrine regulation of lactation: Sarah pointed this out to a patient when she was describing how to increase milk supply.

It was such a treat to shadow Sarah Glenn, this IBCLC who goes out of her way to provide many services for the parents in her community and who has had over 35 years of working with families in the perinatal season. May this post inspire you to implement one or two new techniques for your patients.