I have read the document http://www.ilca.org/files/USLCA/Resources/Publications/Containing_Health_Care_Costs_Help_In_Plain_Sight_2ndEdition.pdf and followed up on the most recent discussions on the proposed and impeding licensure of IBCLCs. I have also spend a lot of time studying the proposed action plan by Surgeon General to overcome barriers to breastfeeding in the United States.

I have to say that proposed licensure will most likely have a negative impact on mother-to-mother and peer support of breastfeeding in the United States as it will most likely restrict what women can do for each other in favor of paid IBCLC services. The idea of licensure will achieve the goals of lactation consultant profession, however the benefit to the public is highly questionable. Licensure usually protects the profession, not the public. I second the lone opinion once aired here in favor of voluntary certification and against licensure.

I would encourage everybody to read the article Professional Licensure and Quality:
The Evidence by Stanly Gross with a specific emphasis on quality of healthcare services and licensure http://www.cato.org/pubs/pas/pa079.html In short, there is little, if any evidence, that links licensure with quality or access to "care".

Also there is no evidence that medical approach to breastfeeding on a country level anywhere in the world impacted breastfeeding duration. Correct me if I am wrong. Breastfeeding behavior is not medically, but socially determined.  If anything, this is public policy issue, not a medical problem. As The Surgeon General’s Call to Action to Support Breastfeeding states that most of the barriers to breastfeeding are social in nature, not medical.

Natalie Wilson
Professional Liaison 
La Leche League of North Carolina

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