Those of you who attended ILCA 2006 may recall Kay Hoover's welcome spech, 
where she alluded to a Philadelphia-based, population-based study on IBCLCs 
in the hospital (for which she was the second-listed author).  It has now 
been published -- and provides an evidence-based *epidemiologic* study 
showing that having IBCLCs on staff at a hospital -- even part-time -- 
increases the rates of BF at discharge among ALL groups of women, but 
particularly amongst the groups of women who were least likely to BF.

The numbers are staggering. Here is one eye-popper: "Among Medicaid 
recipients, the odds of BF at hospital discharge were 4.13 times higher for 
women who delivered at a facility with an IBCLC than women who delivered at 
a facility without an IBCLC. Delivering at a facility with an IBCLC was 
associated with a three times increase in the odds of BF at hospital 
discharge among mothers younger than 20 years and among women who 
experienced a poor birth outcome."

The conclusion states that it cannot identify exactly what it is that IBCLC 
presence does to increase BF: increased individual contact with moms? change 
in staff attitude or policy? But who cares? This study tells us, based on 
demographic data, that *IBCLCs* increase BF rates.

Now, this may seem like a "Doh" study to those of us in the field, but it is 
important for several reasons:

(1)  We now have powerful statistics to show that the *IBCLC* credential has 
demonstrated and proven ability to increase BF rates.  This study proves the 
value of hiring a holder of the "gold standard" credential.

(2) Hospital administrators and number-crunchers are going to be wowed by 
these numbers.  These numbers ought to knock the socks off of any hospital 
administrator who is concerned about the "costs" of hiring an IBCLC. 
"Several studies estimated that the medical costs for infants who are not BF 
exceed those of BF infants by approx $400 annually per infant."

In other words, we can take lactation consultant promotion out of the realm 
of what I call "warm fuzzy mommyness," and into the cold hard realm of the 
bottom dollar. And that may be what is needed to enhance and promote our 
profession, and our IBCLC credential.

Here is the Pub Med abstract:

1: J Public Health Manag Pract. 2006 November/December;12(6):578-585. Links
A Comparison of Breastfeeding Rates in an Urban Birth Cohort Among Women 
Delivering Infants at Hospitals That Employ and Do Not Employ Lactation 
Consultants.Castrucci BC, Hoover KL, Lim S, Maus KC.

Brian C. Castrucci, MA, Director, Family Health Research and Program 
Development Unit, Texas Department of State Health Services, Austin. 
Kathleen L. Hoover, MEd, IBCLC, is Lactation Consultant, Division of 
Maternal, Child and Family Health, Philadelphia Department of Public Health, 
Philadelphia. Suet Lim, PhD, is Acting Director, Division of Chronic Disease 
Prevention, Philadelphia Department of Public Health, Philadelphia. 
Katherine C. Maus, ACSW, LSW, is Director, Division of Maternal, Child and 
Family Health, Philadelphia Department of Public Health, Philadelphia.

OBJECTIVE: To compare rates of breastfeeding at hospital discharge between 
facilities that employ and do not employ International Board Certified 
Lactation Consultants (IBCLCs). METHODS: This study used a cross-sectional 
design. Data from 11,525 birth certificates of Philadelphia residents who 
delivered in 2003 were used. Breastfeeding was assessed using a question 
included on the Pennsylvania birth record, "Is the infant being breastfed at 
discharge?" The Philadelphia Department of Public Health's lactation 
consultants collected information on number of hours worked annually by 
IBCLCs by facility. RESULTS: After adjusting for race/ethnicity, education, 
insurance status, age, marital status, route of delivery, birth weight, and 
gestational age, delivering in a hospital that employed an IBCLC was 
associated with a 2.28 (95% confidence interval [CI] =1.98,2.62) times 
increase in the odds of breastfeeding at hospital discharge. Among women 
receiving Medicaid, delivering at a hospital that employed IBCLCs was 
associated with a 4.13 (95% CI =3.22,4.80) times increase in the odds of 
breastfeeding at hospital discharge. CONCLUSIONS: The findings presented 
here identify an association between delivering at a facility that employs 
IBCLCs and breastfeeding at hospital discharge. As the strength of this 
association is not negligible, particularly for women on Medicaid, these 
findings may be used to encourage widespread use of IBCLCs.

PMID: 17041307 [PubMed - as supplied by publisher]

Liz Brooks, JD, IBCLC
Wyndmoor, PA, USA

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