Birth is a significant life event and generally a happy one. Although labor is often challenging, it can also be empowering, with mothers experiencing elation and strength. Unfortunately, for other women, birth can be difficult, can be overwhelming, and can lead to psychological trauma. Some women may experience depression and posttraumatic stress disorder (PTSD) following their births. These effects can last for years and can cause difficulties in women’s relationships with their partners and their babies. Difficult births can also negatively affect breastfeeding. This article describes the prevalence of PTSD after childbirth and summarizes the symptoms so that International Board Certified Lactation Consultants (IBCLCs) can help recognize it and refer mothers to appropriate resources.

Difficulty with breastfeeding in the newborn and new mother population is all too common, and too little is known about the type of healthcare assistance most relevant to these families. Therefore, 18 mothers were interviewed for their experiences with suboptimal breastfeeding and their perceptions of the healthcare they had received for the problem. These mothers attended an interdisciplinary breastfeeding clinic (midwifery and chiropractic) on the south coast of England. The goal of this study was to better understand mothers’ preferences in healthcare resources to facilitate the most efficient and effective assistance to improve breastfeeding for mothers and infants. The main themes were that mothers desired ongoing reassurance and contextualized, nonconflicting advice that was specific to their baby.

To support mothers to breastfeed for recommended durations, information and support are needed from multiple sources. Our previous research indicated not all mothers in our community receive support, with mothers at greater risk of breastfeeding cessation (e.g., lower educational attainment, enrolled in Special Supplemental Nutrition Program for Women, Infants, and Children [WIC]), receiving supports at lower rates. In addition, receiving support was not always linked to breastfeeding outcomes. Building from these findings, the current report presents a case study of one community and calls for efforts to coordinate care across contexts. Perspectives are provided by lactation professionals in WIC and hospital settings. In addition, a mother who experienced inconsistencies in information and support when she encountered breastfeeding challenges discusses her experiences. Clinical implications are provided for coordinating care across community and healthcare contexts in our community and beyond.

The Surgeon General’s 2011 Call to Action on Breastfeeding (U. S. Department of Health and Human Services, 2011) encourages greater use of International Board-Certified Lactation Consultants (IBCLCs) to increase breastfeeding rates. The objective was to examine IBCLCs’ experiences as part of a routine, primary-care based team serving low income, minority populations, and to elicit their recommendations for implementing IBCLC support as routine in prenatal care. Using a predesigned interview guide, a debriefing session was held with three IBCLCs who served as interventionists in two NIH-funded randomized controlled trials (RCTs) of breastfeeding promotion interventions. Themes were identified through coding and analysis of the session transcript. The results indicated that healthcare provider (HCP) support for breastfeeding was undermined by inadequate education and experience, often resulting in support "in name only." In addition, IBCLCs rapport and expertise—with both women and the healthcare team—helped overcome individual- and system-level barriers to breastfeeding. IBCLCs’ acceptance and integration into the primary-care team validated their work and increased their effectiveness. IBCLCs comments suggest that mothers cannot rely solely upon their healthcare providers for breastfeeding education and support. IBCLCs integrated into routine antenatal and postpartum care are pivotal to encouraging and reinforcing a woman’s choice to breastfeed through education, as well as emotional and skill-based support.