In regard to Barbara and Janice's comments:

Janice I agree with you the requirements should be stiffer to become
certified, but what I think would be more effective than just to raise the
passing grade on the exam is to inact stiffer prerequisites to sit the exam.
 One exampls:   Recently a participant at a seminar where I was teaching came
up to me on a break.  She said "Do you mean that breastfed babies don't need
bottles of water between feedings?"  This women had all the prerequisites and
was going to sit for the exam in 4 months!!!  Now she had "the required
number of hours" counseling breastfeeding mothers to put on her application,
but it was obvious she had been counseling INCORRECTLY.   How can bad hours
of counseling count?   I think about my nursing education.  Before we were
allowed to sit for our licensure we had to graduate from an accredited
school.  We had to practice our craft under the direct supervision of
capable, knowledgable teachers.  We had to study, practice, and PROVE our
compentency and skills in writing AND with practical application.  Then when
our school was satisfied and we graduated after passing many tests on the
many subjects that our profession included, we could sit for our boards and
licensure.  It is a well known fact that no test can prove a person's
compentency in all areas.  Some people are great test takers but can't
function and actually "do".  That's why schools use more methods of
evaluation that written tests alone.
Our LC requirements are pitiful right now. People just have to talk to
nursing moms for a lot of hours, sit through 30 hours of continuing ed on
breastfeeding and pass 1 test.  Noone has to listen to their counseling.
 Noone has to see the results of their counseling.  Some institutions want
some of their people certified and the supervisor, who is not knowledgable
about breastfeeding signs the recommendation because the candidate  has
"worked in the nursery for 15 years"  so of course she has worked with
breastfeeding moms.   I know people from all settings who have passed the
test, but can't latch a baby on the breast.  The hours of clinical experience
need to come AFTER and in conjunction with the education.  LC candidates need
to work under the direct supervision of knowledgable, capable IBCLCs to
practice and prove minimum skills.  There are enough LCs working now so that
mentoring programs could be set up.  I also think there should be an advanced
exam for those practicing on a higher level.  Those who reach this level
whould be great mentors.
Another pet peeve of mine are professionals who complain biterly about the
requirements and cost of being certified, because they already are so learned
and competent in another speciality and have been to a lot of school.  They
want the certification easily, and want the extra initials after their names.
 Competency in one field, RN, MD, RD, etc. does not entitle one to be an
IBCLC without the education in THIS field.  Yes, for our profession to be
credible in the eyes of others we need higher standards or we are going to be
dismissed as just a group with no knowledge behind the intitals.  IBCLC will
mean nothing.
I have written my ideas to the IBLCE board previously and I know they are
working to change the prerequisites gradually over time, but it seems like a
snails pace.
Comments please.

Jane Bradshaw RN, BSN, IBCLC
LLL
Private Practice in Lynchburg, Virginia
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