Lactation Consultancy: Experts of Instinct?

Since the 1990s, Australian lactation consultants (LCs) have grown in prominence within institutions that have, as their overarching philosophy, a medico-scientific framework. LCs working in hospitals and community based centres negotiate a difficult path [1]. The LC in Australia combines the potentially conflicting maternalist philosophy which emphasizes the naturalness of breastfeeding with a scientised and medicalised training which ultimately results in the creation of a professional “expert” in lactation [1]. This exploratory study of Victorian LCs finds that the growth of lactation consultancy as a specialist in breastfeeding has occurred alongside the scientification of breastfeeding. This has resulted in breastfeeding’s legitimation as an optimal practice within medical viewpoints and institutions. LCs’ professional identity and status is bolstered due to their medico-scientific training and professional certification processes. Their structured training also distinguishes their identity from other providers of infant feeding such as doctors, midwives and Australian Breastfeeding Association councellors [1]. The LCs in this study find that science and a “problem-oriented” model is not only central to the success of their mostly “once-off” care[1] but often expected by mothers who are increasingly grounded in medicalised explanations of the lactation process. On the other hand, LCs expressed views of mothers being embedded in an overly scientific breastfeeding practice, often interfering with the “naturalness” of lactation. At a societal level, LCs have illuminated possible conflicting standards between promotion of other health behaviours that have been scientifically proven, and the promotion of breastfeeding. This paper explores the uniqueness of, and the conflicts associated with the LC role, professional identity and medico-scientific discourse. It will also outline, from the eyes of the LC, the inconsistencies and contradictions within and outside their role that draw on the wider debate of the scientification of breastfeeding.