My working life ... Lactation consultant

Emma Pickett is a certified lactation consultant. She works independently, providing one-to-one breastfeeding support to women in north London.

'Many different people support breastfeeding in the UK, such as midwives, health visitors and voluntary breastfeeding counsellors,' she says. 'Being a lactation consultant is a paid role, although a few local authority areas may hire breastfeeding counsellors as peer supporters. Some lactation consultants work in hospital settings or in teams, but I work in private practice.

'I provide consultations part-time, usually two sessions a day, because I have two children and need to collect them from school in the afternoon. Each lasts 90 minutes, sometimes longer, and is delivered in the mother's home. Usually her partner will be present and maybe another friend or relative. It's good to have another pair of ears because at that stage mums are often tired and unable to take in information.

'I'm typically called to help when a mother is experiencing pain. I begin by taking a history of the baby, their birth and weight. Then I observe a feed. Usually I can suggest solutions immediately, such as changing the way the mother is holding the baby or how the baby is attached. Sometimes the baby's mouth isn't open wide enough or the chin isn't making good enough contact with the breast. Often, giving some advice is enough.

'Another common concern is babies not putting on enough weight, so I advise how to improve the baby's intake and sometimes increase milk supply. Some mums have more complex problems, like having had breast surgery. Sometimes the baby has a medical condition, such as tongue-tie.

'I always write everything down and leave notes on what we've discussed. Clients can contact me by email or phone afterwards, but less than half need a second visit.

'After a session, there's little paperwork to do apart from some general administration. Most of my business comes through word-of-mouth, or people searching a database on the Lactation Consultants of Great Britain website.

'I also encourage mums to join me at one of my free breastfeeding groups. As well as offering paid-for services, I run three free breastfeeding groups a week as a volunteer for the London Borough of Haringey local authority.

'I dedicate two hours a week to a helpline run by the Association of Breastfeeding Mothers (ABM). I originally trained as a mother supporter with this charity after my son was born. I realised many people were giving up breastfeeding when they didn't want to, simply because support is lacking. Midwives are very stretched. Although more than 70 per cent of new mothers begin breastfeeding, after six months only 33 per cent are doing any breastfeeding, even though the NHS recommends mums breastfeed exclusively for the first six months.

'When breastfeeding goes right, it's such a precious part of new motherhood. There are people who choose not to, which is absolutely fine, but for those who were unable to do it, it haunts them. According to research, 90 per cent of people who stop in the first two weeks didn't want to. Just one sentence I say can change everything, which is a great feeling. And it's not just the mum you're helping, but the baby too.'

CV

Employment history

1995-2000: Primary school teacher, St Augustine's Church of England Primary School, Kilburn, London

2000-2004: Deputy head, St Stephen's Church of England Primary School, Paddington, London

2007-present: Volunteer breastfeeding counsellor, Haringey, London

2011-present: Independent International Board Certified Lactation Consultant (IBCLC), Haringey, London

Qualifications

1994: American Studies BA, University of East Anglia

1995: PGCE, Bath College of Higher Education

2007: Breastfeeding counsellor, Association of Breastfeeding Mothers

2011: Certificate in lactation consultancy, International Board of Lactation Consultant Examiners

TRAINING

Certification for lactation consultants is only offered by the International Board of Lactation Consultant Examiners (IBLCE). It is achieved by passing an exam set by the body, but the requirements for applying to sit the exam are high. IBLCE has three routes, all of which require applicants to complete university-level courses in 14 subjects such as biology, human anatomy and child development. Depending on your clinical experience, you may also have to complete 90 hours of lactation-specific education and have 1,000 hours of experience working with breastfeeding mothers in the five years before you take the exam.

Ms Pickett achieved certification by volunteering as a breastfeeding counsellor. Four charities offer this training: ABM, the National Childbirth Trust, The Breastfeeding Network and La Leche League. All require women to have breastfed themselves - some for at least six months. Training takes up to two years.

'The exam is designed to be the equivalent of a post-graduate qualification so it's pretty intense,' she says. 'If you've done nursery nursing, some of those courses would be applicable and replace some of the 14 modules, such as first aid.'

USEFUL WEBSITES

International Board of Lactation Consultant Examiners, www.iblce.org

Association of Breastfeeding Mothers, www.abm.me.uk

Lactation Consultants of Great Britain, www.lcgb.org.