When I first became a pediatric speech-language pathologist, I knew that feeding was going to be an important part of my clinical work. I loved working with children and helping families navigate the challenges that can come with eating, drinking, and developing oral-motor skills.
But over time, I realized that there were pieces of the feeding puzzle I wanted to understand more deeply. What was happening before a baby ever came to feeding therapy? How did breastfeeding and bottle-feeding experiences influence later feeding skills? How could I better support families who were struggling long before their child was eating solid foods?
That curiosity first led me to take a structured course to become a Certified Lactation Counselor (CLC). After passing my exam, I connected with a local Breastfeeding Center as their on-site Speech Therapist to help support their current clients. I became so passionate about early feeding skills and working with this population, that it eventually led me to become an International Board-Certified Lactation Consultant (IBCLC).
Adding my IBCLC credential to my pediatric SLP background didn’t change who I was as a therapist. It expanded my toolbox. Perhaps more importantly, it changed the way I look at the whole feeding journey and allowed me to support families from the very beginning.
Two Credentials, One Bigger Picture
Speech-language pathology gave me a strong foundation in communication, oral-motor development, swallowing, and pediatric feeding. Lactation added another layer. The coursework centered on milk production, early feeding behaviors, sucking and swallowing skills, and the family role and connection in feeding.
Instead of looking at mealtime as something that begins when a child starts eating solids, I began thinking about feeding as a developmental continuum.
Each stage builds on the skills that came before it. When something isn’t working, sometimes the most helpful question isn’t simply: “What skill does this child need to work on?” It is more helpful to understand:
“Where did feeding become difficult?”
That shift in perspective has influenced the way I evaluate and treat pediatric feeding disorders.
My Toolbox Got Bigger
One of the biggest benefits of having both credentials is that I can bring different clinical lenses to the same child.
For example, a baby who is struggling with bottle feeding may not simply have a “bottle aversion.”
I might consider:
- Oral-motor skills
- Suck strength and coordination
- Suck-swallow-breathe coordination
- Bottle and nipple selection
- Flow rate
- Positioning
- Oral anatomy
- Tension or restriction
- Endurance and fatigue
- Sensory responses
- Medical history
- Previous feeding experiences
- Caregiver positioning and feeding techniques
Together, those perspectives allow me to look at the whole child rather than just the feeding behavior.
It Also Expanded the Children I Can Serve
One of the most rewarding parts of combining these areas of expertise has been seeing how many different families can benefit from a therapist with knowledge across both disciplines.
My clinical toolbox now allows me to work with children across a much broader portion of the feeding journey, including:
Infants
Some feeding challenges begin well before a child ever eats a bite of solid food. Infants may present with difficulty latching, inefficient feeding, poor oral-motor coordination, fatigue during feeds, difficulty managing bottle flow, or difficulty coordinating sucking, swallowing, and breathing. While most of my clinical work focuses on children who are already experiencing feeding challenges, my IBCLC credential allows me to see families who are searching for general education on breastfeeding or support with latching.
I’m able to set up families with a strong foundation and understanding of feeding development and establish report and connection long before a feeding delay may present itself. A baby who has good breastfeeding skills but later struggles with bottle transition or starting solids now has a direct line to an experienced therapist. In my experience, families I have seen for early breastfeeding support, do not delay in reaching out for help with other parts of the feeding journey.
— April Anderson, MA, CCC-SLP, IBCLCBottle Refusal & Feeding Difficulties
Bottle refusal can be incredibly stressful for families. Rather than viewing refusal as simply a behavioral issue, I want to understand why the baby is refusing.
- Is the flow too fast or too slow?
- Is feeding physically difficult?
- Is there a history of discomfort?
- Is the infant having difficulty coordinating the feeding pattern?
- Is there a sensory component?
- Has the baby developed a negative association with feeding?
These questions can lead us toward very different treatment approaches.
Oral Restrictions & Tongue Ties
Tongue ties and other oral restrictions are another area where having knowledge of both lactation and speech-language pathology can be valuable.
Children With Oral-Motor Deficits
As an SLP, oral-motor development has always been an important part of my clinical toolbox. But understanding infant feeding has helped me see those skills across a much longer developmental timeline.
Sucking, lip closure, tongue movement, jaw stability, bolus management, chewing, and cup drinking aren’t isolated skills. We know that they develop over time, and sometimes understanding the earlier stages helps us better understand the challenges we’re seeing later.
Your Credentials Are Tools — Use Them Together
Obtaining my IBCLC credential didn’t give me a completely new profession. It gave me another perspective. I now have more questions to ask families to understand their feeding journey. I have more resources to offer families, and more ways to think about the “why” behind a child’s feeding difficulty.
One thing I’ve learned throughout my career is that additional credentials aren’t simply letters that go after your name. They can become additional tools in your clinical toolbox.
My SLP training didn’t become less valuable when I became an IBCLC. My IBCLC training didn’t replace my SLP training. Instead, they started working together.
— April Anderson, MA, CCC-SLP, IBCLCAnd that combination has allowed me to expand the population I serve, approach feeding challenges from multiple perspectives, and better support families through different stages of their child’s feeding development. It has also given me an added sense of visibility and credibility among other professionals such as pediatricians, pediatric dentists, and gastroenterologists that I have the knowledge and experience needed to support their patients.
For me, that’s what interdisciplinary practice is about: Bringing different areas of knowledge together to better understand the whole child.
A Note for Fellow Therapists
If you’re a therapist considering an additional certification or specialty, I encourage you to think beyond simply adding another credential to your resume.
- What population could this allow me to better serve?
- What questions would I be able to answer differently?
- What gaps in my current toolbox could this fill?
And most importantly: How could this new knowledge complement, not replace, the expertise I already have?
For me, becoming an IBCLC did exactly that. Depending on your setting, it’s possible that taking additional coursework on bottle feeding, latch and positioning, or early feeding behaviors for continuing education hours may be sufficient. However, if you are looking to expand your caseload, work with more infants and their families, and support your community with an added profession of being there from the very beginning, then setting your sights on becoming an IBCLC may be the next step for you.