Unfortunately, demand for our program often exceeds our capacity to see patients.

Infant feeding support ideally should happen now, not weeks later. Unfortunately, wait times for our clinic currently range from 1 to 12 weeks, depending on referral volume.

While our team is working diligently to improve access and shorten wait times, this delay is largely due to a shortage of physicians in Edmonton with advanced training in lactation and infant feeding. Currently, Northern Alberta is served by only 7 physicians fully trained in breast/chestfeeding and infant feeding medicine, while Calgary alone has more than 25.

Edmonton and Northern Alberta require the same number of physicians, if not more, to achieve the gold standard of timely access to care within 1 week. Despite these significant limitations, our office has helped countless dyads work toward their feeding goals and continues to advocate for the development and expansion of programs like ours.

What makes a lactation & infant feeding clinic like Willow Family Medicine unique?

A lactation and infant-feeding clinic does more than support an infant; it supports both the infant and the primary caregiver. We recognize that feeding challenges are often complex and multifactorial. They may be influenced by physical or medical conditions, as well as social and psychological factors.

Clinics like Willow Family Medicine offer more than feeding support or procedural interventions. They also provide expertise in:

• the science of lactation

• breastfeeding/chestfeeding medicine

• infant feeding and nutrition

• fourth trimester and primary care

• reproductive health

• pediatrics

• mental health & psychiatry

Patients who receive collaborative, continuous, and comprehensive care early on are more likely to achieve better outcomes with greater ease, at lower cost, and with less psychological burden.

Recommended credentials when seeking care

In keeping with recommendations from the Academy of Breastfeeding Medicine, we encourage patients to seek care from providers who hold the following qualifications:

1. North American Board of Breastfeeding and Lactation Medicine (NABBLM-C) and/or International Board Certified Lactation Consultant (IBCLC)

   AND

2. Medical Doctor (MD) or Nurse Practitioner (NP)

   OR

3. Registered Nurse (RN) IBCLC working in direct collaboration with an #1

Other support options in Edmonton

Many other clinics and support services in Edmonton (for example, CLCs, LPNs, and RNs) may be available to patients at a cost and often have shorter wait times, or none at all. The training level of these allied health providers can vary significantly. A list can be found here.

While these services can be helpful for normalizing breast/chestfeeding and providing foundational support, they may not be able to fully manage more complex concerns. For example, they may not be able to:

• diagnose or manage medical conditions

• order investigations

• prescribe medications

• refer to specialists

• perform procedures such as:

• frenectomy

• abscess drainage

• obstructed milk pore excision

Breast/chestfeeding, lactation, infant feeding, and infant nutrition are areas of medical expertise. As with any other medical condition, such as diabetes, patients with more complex feeding concerns may require care from an interdisciplinary medical team.

This may include physicians, nurses, and other allied health professionals working collaboratively within Alberta’s healthcare system.

Additional physician-led clinics in Edmonton

Additional physician-led clinics in Edmonton may include the following: wait times may vary.

• Allin Clinic - Downtown Edmonton - Referral required

• Anderson Hall - Indigenous Wellness Clinic - Downtown Edmonton - Patients may self-refer and do not need to be Indigenous to access this service

• Misericordia Community Hospital - Breastfeeding Clinic - Referral required

• Village Lactation - St. Albert - Referral required

Physician-led clinic options in Calgary

Patients may also wish to consider seeking support in Calgary through one of the physician-led clinics. This is where Dr. MacGregor received her early training, and the support offered at these clinics reflects a similar philosophy and approach to care to that of Willow Family Medicine.

Because Calgary has more trained providers, wait times may be shorter. Dr. MacGregor and her team will always assume care once your appointment date arrives, regardless of whether you have accessed care elsewhere in the meantime.

These clinics include:

• Well Fed - East & West - Referral required

• Circle Medical - Referral required

Additional allied health assessment

Patients may also consider obtaining a skilled feeding assessment from a Dentist or Speech-Language Pathologist (services that are typically not covered by Alberta Health) to help clarify the functional components of infant feeding. However, this should ideally occur alongside comprehensive support for both the feeding parent and the child.

In an ideal clinical setting, a community-based lactation and infant nutrition clinic would include an interdisciplinary team such as:

• physicians certified as NABBLM-C

• nurse practitioners

• registered nurses

• speech-language pathologists

• dietitians

• psychologists

• pediatricians

• social workers

• psychiatrists

• physiotherapists

• with access to pediatric otolaryngologists and pediatric dentists as needed

Unfortunately, this type of collaborative clinic does not currently exist under one roof in Edmonton. Instead, families often navigate a fragmented network of referrals and services, often coordinated through clinics like Willow Family Medicine.

Questions to ask when choosing a provider

Regardless of where you seek support, especially when paying out of pocket, it may be helpful to ask:

• What type of follow-up will I receive? Is there a time limit or complexity limit to that follow-up?

• What happens if my situation is more complex than expected? Who does this provider refer to, and how long might that process take?

• Can this provider support both the primary feeding parent and the infant? Breast/chestfeeding and infant feeding involve three patients:

  • the primary feeding parent

  • the child

  • the dyad as a unit

A note on travel, private-pay care, and frenectomy

While travelling to Calgary may be less convenient, feeding challenges are often more complex than they first appear and may require a higher level of expertise than some providers can offer. In addition, the financially incentivized nature of private-pay frenectomy (often costing families $500–$1000), combined with the shortage of physician-led infant feeding care in Edmonton, has created space for less-experienced providers to attempt to fill this gap.

Unfortunately, some patients arrive at Willow Family Medicine worse off than they may have been had they waited or accessed care in Calgary. That said, many families do have positive experiences with non-physician-led care, and outcomes vary widely.

If contemplating private-pay frenectomy

If you are considering a private-pay frenectomy, a few recommended providers include:

• Dr. Enoch Ng, DDS – Enjoy Dental – Edmonton, Alberta

• Karrie Page, SLP – Tip of the Tongue - Can help direct families to appropriate care in Central Alberta through consultation with herself or her team.

Thank you for your patience as we all help build a robust, evidence-based lactation and infant feeding network in Northern Alberta.