Lisa Paul asked many questions regarding couples counseling and breastfeeding. Her questions are in quotes below. My answers follow each of her questions.
"I know this is a topic of conversation at LLL meetings, and among mothers, but who do you all refer to if the couple is having significant difficulties as a couple?" A mental health care provider who is knowledgeable about and supportive of breastfeeding. See my article below for questions that can help identify one. Check with local doulas, midwives, ICAN support groups, and breastfeeding support groups to see who has a reputation as being able to provide breastfeeding-compatible mental health care.
"I am assuming that LC's don't do couples counseling or do they?" LCs do *not* provide couples counseling unless they hold dual credentials as a lactation consultant *and* a mental health care provider.
"How do LLLL handle this situation?" If asked in a meeting, an LLL Leader would facilitate discussion among mothers regarding how they have coped with the issue. Also, LLL Leaders and Groups may ma intain lists of referral options for mothers who need to consult with a specialist regarding issues outside the capacity of LLL Leaders to address. Mental health care providers may be on those lists. Leaders do not "endorse" or "recommend" a particular health care provider or mental health care provider. If a Leader does not know mental health care providers to whom she can refer a mother and/or she feels the mother's questions have a legal or medical aspect, then she should consult with her Professional Liaison for help and refer the mother to her primary health care provider for evaluation and a referral to one or more mental health care providers . LLL Leaders can also refer mothers to a variety of resources on the LLLI website related to sexuality and breastfeeding (just type in sexuality in the search box and you'll pull several up). LLL Leaders are trained to use a variety of communications skills when talking with mothers in person, on the phone, or by email to help them express t heir thoughts and feelings and to figure out what their options are . There are many LLL Leaders here on Lactnet who can address this question as well.
"What tools are available for a couple who finds breastfeeding the battleground?" Some LLL Groups offer family meetings which can be helpful by providing information for the people who make up mothers' support systems, normalizing many experiences related to breastfeeding, and offering ideas and support for coping with challenges related to breastfeeding and being parents. Referral to a mental health care provider who is knowlegeable about and supportive of breastfeeding can help couples work through the challenges they are facing. Resources related to sexuality and breastfeeding that can be found on the LLLI website may be helpful for a couple to read individually and/or together.
"Have any of you had experiences with counselors who were detrimental to the breastfeeding relationship? Who suggested weaning as the best solution, perhaps?" Definitely. This happens far too frequently (see my last answer below). Therefore, it is very important to try to ascertain the attitude, beliefs, knowledge, and skills of a mental health care provider in regard to breastfeeding before engaging in therapy with them (see my article below).
"How important is it to have a counselor who has had breastfeeding experience either personally or as a partner?" This can help, but not all breastfeeding experiences are the same. If a counselor had a negative experience and/or breastfed for a short duration and/or cannot relate to the mother's unique experience of breastfeeding and/or her values and goals related to breastfeeding , then a counselor's personal experience (or the experience of a partner) may not be helpful at all. Mental health care providers who rely solely on their own experience with breastfeeding (or their partner's experience with breastfeeding) are not likely to know enough to be able to fully support breastfeeding in the context of mental health care.
"I have done some internet searches, without much luck. Please feel free to point out if there is a particular researcher or expert in this field that I should be reading. This is a simple paper but I find this subject fascinating, and will read above and beyond what is required for the paper." As a clinical counselor and International Board Certified Lactation Consultant who has provided mental health care to breastfeeding mothers and their partners and as the founder and moderator of LactPsych (an email discussion group for professionals with substantial credentials, focus, and experience in lactational psychology), I can tell you that many mothers experience difficulty finding breastfeeding- compatible mental health care. So much so that they often go without treatment in order to not undermine breastfeeding. I am currently on extended leave from my private practice due to the needs of my adopted daughter. But, when I was providing mental health care services in my private practice, in addition to working with in-person clients, I even worked by phone with clients across the US and from other countries because they needed a mental health care provider who focused on lactational psychology but could not find one in t heir corner of the world .
You may find the following two articles of interest:
"Regarding the Emerging Field of Lactational Psychology" ( http://jhl.sagepub.com/content/22/1/11.full.pdf ) addresses the junction of the fields of lactation and psychology.
Mental Health Care for Breastfeeding Mothers with Postpartum Depression ( http://www.lifecirclecc.com/files/Mental_Health_Care_for_Breastfeeding_Mothers_with_Postpartum_Depression_20122.pdf ) offers questions that can be asked of mental health care providers to gauge their knowledge and support of breastfeeding in the context of mental health care, regardless of the psychological issue at hand.
If you are on facebook, please feel free to visit my new lactational psychology focused facebook page at: www.facebook.com/CGoodMojab .
Best wishes with your paper!
Cynthia
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Cynthia Good Mojab, MS, IBCLC, RLC, CATSM
www.lifecirclecc.com h t t p : / / lactspeak.com/speaker/cynthiagood-moj a b
www.facebook.com/CGoodMojab
http://lifespantkd.blogspot.com
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