Advice for starting out in private practice as an IBCLC

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What’s something you wish you were told when starting private practice?

I wish I had been told that being an IBCLC could actually be a career, not just a paid hobby. At the time I became an IBCLC, I had small children and wanted work that I could do on my own schedule so I could be with them. Thanks to my husband’s job, we didn’t need my income. But as time has gone on, and my private practice has thrived, I’ve seen that my income can support our family. I wish I had been told to think more like a businessperson from the start.

But this opens up an uncomfortable point. I’m able to say all of this because I have privilege. I am a member of my country’s dominant culture, I am cisgender, and I had the economic stability to be able to afford to become an IBCLC. For aspiring IBCLCs of color and/or of lower economic status, there are significant and truly heartbreaking barriers to entry that I desperately want to see destroyed. Please read this article by Kimberly Seals-Allers and to learn more.

For those in the US, licensure efforts can be used as a weapon against community-based lactation workers of color. The IBCLC is the gold standard for clinical care--you'll never hear me say otherwise--but if we have a myopic view of the credential that doesn't account for the racial and economic barriers towards achieving it then we will never be more than just a bunch of middle-aged white ladies with our Birkenstocks and our Subarus.

Time and again, I have personally heard IBCLCs of color share that they were unable to make connections in their local communities when starting their businesses. Were the white IBCLCs specifically and personally discriminating against them? Perhaps not intentionally or malevolently, but if those of us with privilege don't truly acknowledge that we were born on third base but think we hit a triple, then we are working against our colleagues of color. We are the problem. 

With such low breastfeeding rates across the board, instead of turning people away from the table we need to get a bigger table. Families benefit when we work together. Collaboration, inclusion, and expansion are the way forward. Not division—that only helps the formula manufacturers. 

So if you have privilege don’t just feel sad about it, use your privilege to listen, learn, and change. I’ve made my own personal commitments to putting others first, even (and especially) when it costs me time, money, status, or power. I've also made a personal pledge to listen and reflect, instead of speak and react, if someone of color tells me I'm doing something wrong. It’s hard and scary, but absolutely worth it on every level because I believe things can change if we put in the work.

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About the Author

Annie Frisbie, MA, IBCLC is the creator of the Lactation Consultant Private Practice Toolkit, a collection of books, resources, legal forms, training manuals, and workbooks aimed at helping private practice lactation consultants build a private practice that’s ethical, profitable, sustainable, and enjoyable.