Hear, hear! to Nikki Lee and Lisa Marasco for their thought-provoking posts
about the quandry for IBCLCs, whose practice-guiding documents do not
currently support the "power to diagnose," yet whose IBLCE certification
exam questions seem to spring from that very power.
I agree with the speaker Lisa heard, who thinks the detailed assessment and
analysis IBCLCs offer for many difficult lactation/BFg issues (think: our
favorite friend, Mr. Tongue-Tie) make them more than capable of
"diagnosing" this physical condition. Indeed, given our *current* IBLCE
Scope of Practice and Clinical Competencies for IBCLCs, we *should* be able
to do this, and do it well. The "formalized training [to] provide
legitimacy to our right to 'diagnose' lactation conditions" suggested by
Lisa absolutely will
And I will also gently suggest that before we start a flurry of posts about
how some IBCLCs are "good enough" to do this and some are not, that
entirely misses the mark for what we SHOULD be focused on, which is
patient- or client-centered care. Hurling tomatoes at one another in some
sort of contest of "I know more about this than you do," shines the
spotlight on US, as the healthcare providers (HCPs).
I submit that the spotlight should instead be focused on THE FAMILY, and
seeking to provide evidence-based information and support for *their*
infant feeding goals. It doesn't matter one whit that I am the world's
surpreme expert on Lactation Condition X if I am not stopping, sitting
down, making a connection, and ASKING the family what is going on and what
they want or need.
The lawyer in me knows that the IBCLC profession needs practice-guiding
documents that strongly support our clinical skill and authority. With a
discilinary process that transparently, and with basic due process, permits
sanctions for those who do not follow them. I don't think the existing
documents and disciplinary process are perfect, by any stretch. But here
is the deal: It is what we HAVE, and so it is what we must FOLLOW.
The mandatory IBLCE Code of Professional Conduct, Scope of Practice, and
Clinical Competencies are all freely accessible on the IBLCE webiste, and
are a grand total of about 10 pages to read. I think every IBCLC should do
so (that is: read them, word-for-word), at least annually. The voluntary
ILCA Standards of Practice, and Position Paper on the Role and Impact of
the IBCLC, offer further girding for our incredible cross-disciplinary
skill and expertise as members of the healthcare team. That is another 6
pages. Its a foggy day here in Philly. Good day for a little downloading
and reading!
--
Liz Brooks, JD, IBCLC, FILCA
Wyndmoor, PA, USA
Secretary, U.S. Breastfeeding Cmte (2014-16)
Director, Human Milk Banking Assn of North America (2015-18)
Adjunct Professor, Drexel Univ, Public Policy of Breastfeeding (2016)
"IBCLCs empower women and save babies' lives!"-Ursuline Singleton
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