Working at the interface between the art and science of breastfeeding: a qualitative study of International Board Certified Lactation Consultants' experiences.

Abstract

2 This copy of the thesis has been supplied on condition that anyone who consults it is understood to recognise that its copyright rests with its author and due acknowledgment must always be made of the use of any material contained in, or derived from, this thesis. 3 Sarah Jane Brown: Working at the interface between the art and science of breastfeeding: A qualitative study of International Board Certified Lactation Consultants 19 experiences. Abstract Since 1985 a specialist breastfeeding practitioner, an International Board Certified Lactation Consultant (IBCLC), has been in existence. European and global recommendations propose that IBCLCs are employed within health services to support breastfeeding initiatives, however, the research-based evidence is restricted and did not include any description of the experiences of practitioners. The aim of this study was to describe the experiences of IBCLCs in England and in the process understand some of the enablers and barriers of their role. Data was collected through narrative accounts from twelve IBCLCs who worked in the north of England. The first interview asked practitioners to narrate accounts of how they became and practiced as IBCLCs and the second interview, six months later, sought further elucidation on topics that were found to be common experiences to all practitioners. The narrative accounts were analysed through a social constructionist framework where descriptions were drawn into categories, then themes. The four themes were identified as; centred on breastfeeding; developing a breastfeeding practice; chip, chipping away at the breastfeeding practice coalface and maintaining a balance within a professional practice. The IBCLCs described seeking a niche in practice from which they could work with the necessary freedom and autonomy to meet the needs of the breastfeeding dyad. The IBCLCs demonstrated a passion and a woman-centred expertise which led them to being seen as breastfeeding champions. All of the participants extended their role into teaching and managing change in breastfeeding practice but the participants felt underprepared and not well supported for such a role. While the IBCLC qualification provided the professional qualification the participants 19 sought, the study identified issues that needed further consideration.