Study of Lactation Consultant’s Services in Health Facilities in Thailand

Abstract

Lactation consultant nurses play an important role in the promotion of breastfeeding practices and to ensure optimal age-appropriate feeding of children. Responsible for supporting mothers in overcom­ing breastfeeding difficulties, they also play a prominent role in providing knowledge, techniques and skills, as well as instructing mothers on appropriate behaviors and building confidence; the critical factors for successful breastfeeding. In Thailand, professional nurses assigned to lactation clinics in health facil­ities take on the role of a lactation consultant. To date, there have been no studies on service provisions and practices of lactation consultants in Thailand.

This study aimed to understand the situation of lactation consultants working in health facilities, including their roles, knowledge and qualifications as well as the scope of services provided, the chal­lenges faced, and recommendations for improving competency of lactation consultants. A qualitative study was conducted by collecting data from 53 lactation consultants working in public and private health facilities, through focus group discussions and self-administered questionnaires. The results found that lactation consultants had the primary role of providing knowledge and building confidence for pregnant women, mothers and families on breastfeeding, from pregnancy until post-partum period. Lactation consultants’ scope of work was to provide nursing care without invasive interventions which required extensive knowledge focusing on breastfeeding practices, infant formula, maternal nutrition and child development. In addition, they required skills of nursing services, academic and technical skills, as well as communication and administrative capabilities. The large majority of lactation consultants faced difficulties due to their heavy workload, career path uncertainties, and insufficient knowledge of complex breastfeeding complications. These problems were resulted from national and organizational policies, management and the work environment of lactation consultants. Based on these results, in order to improve the capacity of lactation consultants, well-defined national policies and policy implementation on the guidelines and promotion of breastfeeding practices in health facilities, as well as building a net­work for lactation consultants and developing a mechanism for long-term capacity building and moni­toring are recommended.