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When the Supporter Needs Support: Battling Burnout Among Lactation Professionals

Occupational stress and burnout are well documented in the health professions and are associated with enormous personal, social, and economic costs. Lactation professionals (due to the common circumstances of overwork, heavy responsibility, and little authority) may be at particular risk for occupational stress and burnout. As we have become more sophisticated in our understanding of how stress may affect one person differently than another, how stress is related to burnout, and how pathology associated with stress may be avoided, we find that identification of chronic stress is an important skill for all health professionals—selfmonitoring and stress management can make an enormous difference in preventing stress-related disorders and possibly the loss of skilled individuals who may decide to leave the profession. Stress and stress-related disorders have been reported among doctors, nurses, and other health care providers who work intensively with people in physically and emotionally demanding situations. Lactation consultants, whether or not they are also physicians or nurses, must deal with crises daily. They are often called in to see new mothers and infants after early breastfeeding concerns have grown into severe problems that may not be resolved. Emotional and vulnerable mothers, confrontational family members, and difficult interactions with other health professionals all take their toll on well-meaning but overwhelmed lactation consultants. Stress can be even greater in times of economic downturn, when funding for personnel may be cut at the same time that there is an increased need for services. Frustration with limited time and resources may be a daily occurrence. Initially, human beings react to stress with transient hormonal changes, the so-called fight-or-flight response that increases the ability to address the perceived danger effectively. However, with prolonged stress, the body will undergo long-term physiological changes. In the short term, these changes make us feel less alarmed but they leave us functioning in a weakened state. As the stress continues, bodily functions begin to break down as resources become exhausted and illness and burnout occur. Burnout, as described by Maslach and Jackson, contains 3 elements: (1) emotional exhaustion, (2) depersonalization (a tendency to regard people as objects), and (3) a decreased feeling of personal accomplishment (feelings of lack of control, helplessness, and low motivation). Burnout is not resolved through vacations or rest, and results in many individuals leaving their chosen professions. Stress does not affect human beings all in the same way. The pathological effect of an environmental stress is moderated by the ability of the individual to cope with the event or circumstances. If an individual cannot cope or takes a great deal of effort to cope with a stressful event, the physical and emotional response will be unhealthy. Another person may have little difficulty dealing with the same circumstance or may have mastered stress management techniques that result in a more appropriate response. In a study of nurses in 5 Hong Kong hospitals, Taormina and Law evaluated the elements of burnout (emotional exhaustion, depersonalization, and decreased feelings of personal accomplishment) and the associated risk factors within that population. Given that many lactation consultants are nurses or work in medical settings, this study is relevant to understanding burnout within our ranks. In their efforts to plan for future interventions, Taormina and Law examined individuals’ internal skills and environmental influences on the various elements of burnout among the nurses. The researchers theorized that higher scores on measures of interpersonal skills, stress self-management, and psychological preparedness would result in lower levels of