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Lactation Physiology Module

Childbirth International’s certification programs (Birth Doula, Postpartum Doula, Childbirth Educator, and Lactation Counselor) include four modules: Communication Skills; Physiology; Professional Skills; and Business of Birth. Each module has a number of units or topics relevant to your work as a birth and lactation professional. Within a unit, you’ll read the course materials, complete self-guided reflective and critical thinking activities, and view external readings and videos. There may also be additional discussion forums, assignments, quick quizzes, and tests, which are required if you choose to complete the certification requirements.

The Lactation Physiology module covers the knowledge that you need to work as a Certified Lactation Counselor.

Topics in Lactation Physiology

In this module, you will learn about the physiology of lactation, how lactation is established and maintained, addressing challenges the Lactation Counselor may come across, feeding preterm infants, toxicology related to lactation, equipment to support your role as a lactation counselor, and moving beyond lactation. The topics covered in the lactation physiology module include:

  • physiology of lactation
  • positioning & latching
  • establishing lactation
  • addressing lactation problems
  • lactation problems related to infant anatomy
  • illness in the breast/chestfeeding parent
  • feeding the preterm infant
  • feeding in special circumstances
  • drugs & toxins
  • beyond lactation
  • equipment & supplies

An explanation for each unit within the Lactation Physiology module can be found below, together with a table outlining the competencies you will build in each unit.

Physiology of Lactation

Understanding the normal process of lactation is a fundamental requirement for a Lactation Counselor. A solid grounding in what is “normal” and how lactation works at a detailed level enables the counselor to recognize when things are not going right, and, more importantly, why. In this unit, you’ll gain a deeper understanding of how the human body makes milk to provide nutrition for infants.

Certification activities in this unit

  • 21 multiple-choice questions in an open-book exam
Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Briefly describe breast/chest development in humans
  • Describe the anatomical features (related to lactation) of the breast/chest in detail
  • Describe five nipple variations
  • Describe less common nipple variations and their impact on breast/chestfeeding
  • Explain each of the stages of breast/chest development and growth
  • Describe variations in breast/chest shape and their impact on breast/chestfeeding
  • Identify six types of breast/chest surgery that can impact lactation
  • Name the different incisions used in breast/chest surgery
  • Examine anatomical differences in the breast/chest that can affect lactation
  • Examine face, mouth, and pharynx abnormalities that can affect sucking
  • Examine abnormalities of the nervous or muscular systems that can affect sucking
  • Examine the potential lactation problems that can arise from breast/chest surgery
  • Explore the controversies related to a diagnosis of tongue tie
  • Examine how hypoplasia can affect lactation
  • Assess a person’s breasts/chest and document the anatomical features
  • Provide information on interventions that affect anatomical features of breast/chestfeeding

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Positioning & Latching

Positioning and latching form the physical framework for the act of breast/chestfeeding. Effective positioning and latching ensure the baby is getting enough milk and avoids the most common causes of pain.

Certification activities in this unit

  • 6 multiple-choice questions in an open-book exam
Essential KnowledgeContextual UnderstandingAttitudes and Behaviors

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Working With Clients During Labor

This unit will assist you in developing techniques that help you to support a client during labor and birth. You’ll look at positioning, massage techniques, breathing, and relaxation methods, and cover an overview of complementary therapies. You’ll explore how you can communicate with a client on the options available to them for pain relief. You’ll also consider the challenges of being on call and how to create the optimal environment for birth. You’ll examine the difference in your role when you’re at a home birth and how you can support partners and other family members. Finally, you’ll go through the documentation that might be useful at a birth.

Certification activities in this unit

  • Identify the skills used when supporting a birth doula client and their effectiveness
Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Name five different upright positions that can be used for labor
  • Describe the different nerve fibers that relate to touch and pain
  • Describe the role of a doula at a homebirth
  • Name three things a doula can do to support a client’s partner or other family members
  • Consider the impact that different positions have on the angles within the pelvis and on labor progress
  • Evaluate the different effects of firm and light touch
  • Evaluate different styles of breathing
  • Effectively communicate the pros and cons of options available to a client (in relation to pain relief)
  • Create a visualization script that encourages relaxation
  • Plan for being on call, identifying how to manage stress during this period

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Adapting to Labor Circumstances

Labor is often a time of enormous challenges, both physically and emotionally. However, for some, labor is more difficult than for most. In this unit, you’ll look at some of the more common causes of a challenging labor and how you, as a birth doula, can help a laboring client. You will also learn the techniques for Rotational Positioning, a CBI-designed tool to support clients in some challenging births.

Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Describe the impact of sleep deprivation on decision-making
  • Identify a variety of fetal positions and malpositions
  • Name three techniques for supporting a client with a posterior labor
  • Identify three ways that a cesarean might impact a client after the birth
  • Identify four strategies for managing conflict
  • Recognize the impact of fetal position on the fetal head diameter
  • Explain the increased risks for posterior labor and the possible causes of these
  • Explore how Rotational Positioning might be beneficial during a posterior labor
  • Reflect on four ways that a doula can help during an epidural
  • Reflect on personal feelings about being present for an unplanned homebirth
  • Develop a plan for self-care during a long or challenging labor

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Working With Clients Postpartum

A birth doula typically provides 1-2 postpartum visits with a client but might be available for telephone or email consultation for the first few weeks after the birth. In this unit, you’ll look at the services that you can provide during the postpartum period.

Essential KnowledgeContextual UnderstandingAttitudes and Behaviors
  • Identify the common symptoms with a range of perinatal mood and anxiety disorder
  • Reflect on own role in supporting a client with a perinatal mood and anxiety disorder
  • Develop handouts for clients on postpartum issues

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