Dear Lactnetters, I recently posted this message on IBCLC2B, a listserv for aspiring IBCLCs. Many of them are frustrated, discouraged, or have just given up in ever being able to qualify to sit the exam. Among those are non-RNs, midwives, doulas, and others who do care about and support breastfeeding others. Some discussion has been generated by this letter, and I am wondering what you think. Dear Future IBCLCs, Everything I am about to say here is my personal opinion. It should be read as such, and in no way speaks for my past or present employers' views on any of the following subjects. I strongly encourage all of you who are looking at the 2500 -4000 hours of supervised practice hours as hopeless in terms of every becoming an IBCLC to write to the new executive director of the IBLCE (check the website for her name and address) and the Chairman of the IBLCE Board (Dr. Wendy Brodribb, send it to the Falls Church address and she will get it) and explain to them if you feel it is unfair to you to deprive you of the opportunity to become IBCLCs within a reasonable amount of time when you have so much to offer. RN's do not necessarily make the best IBCLCs, and the data used to base the 2500 and 4000 hour requirement is more than 20 years old. It is time, I believe, and perhaps you do too, for a new study to reassess how many supervised practice hours and lactation specific and general medical education hours it REALLY takes educated, intelligent women to become competent, entry-level IBCLCs. Did you know that number of hours required, specifically the 4000 hours, can be accumulated over an indefinite time period? This means that a nurse can count back 20+ years and count post-partum ward hours she did when doctors were still recommending nipple scrubbing with toothbrushes, and she was telling mothers to nurse 3 minutes a side. Those hours were supervised and are valid. Even if a nurse has never stepped beyond the post-partum floor, and every hour of the 4000 is there, and she has never worked with an infant more than 5 days old, she has qualified to sit the exam. And any hours that are that old are very difficult to verify. Yet, they count as valid hours, while hours you spend as doulas, midwives and in other positions do not count because they are not "supervised". This needs to be addressed to make the process more fair for everyone. How this can be done, I am not sure, but I am sure it needs to be addressed. The 3 day and one-week courses with no supervised practice hours and a non-psychometrically valid exam do not truly give you the credential or experience or knowledge you need to become paraprofessionals. They certainly have value for some students, and are excellent orientation courses. You can learn just as much, if not more, however, through independent and group study of Riordan, Lawrence, and the suggested reading list for the IBCLE exam, attending conferences, and shadowing with IBCLCs. A one-week butt in the seat course is not the answer to 'certification' and a medically recognized credential. Five years of La Leche League Leadership comes very close to preparing you for entry-level IBCLC, because you work with a variety of ages of infants, but still it is not complete because LLLI's rarely see NICU babies, premies, or special circumstances babies, but not everyone is cut out to be a LLLL. La Leche Leage Leadership is not simply breastfeeding, it is a way of life, a theory of parenting that includes lifestyle choices other than breastfeeding. It is unethical to become and LLLI, nor does LLLL want potential women who are "using" LLLI as a pathway to IBCLC-dom. I wonder why Pathway F has been temporarily discontinued. It was a valid program that was clearly working. When will the analysis of the data be completed? Read carefully the newly added "news" and "pathway F" paragraphs on the IBLCE website that talk about our credential as an "add on" credential. What does this mean to you? Does it mean that first you do something else like become an RN, RD, or MD, and throw this IBCLC on for the heck of it? Does it mean to you that our profession is discredited? Does it infer, to you, that being a professional lactation consultant is not a real, valid allied health care profession that doesn't deserve to stand alone? When I read this, I immediately felt devalued. Do you aspire to be an IBCLC and nothing else? Do you want a two year AA degree in lactation consulting that would offer you a standardized program, supervised practice hours, and the opportunity to sit the exam at the end of your degree program, much like other paraprofessionals (e.g., respiratory therapists, dental hygenists, etc.)? If any of these issues mean something to you, express your feelings to IBLCE, become ILCA members, and inform the ILCA leadership as well. You don't have to be an IBCLC to be an ILCA member, and your voice counts. ILCA represents all of us, giving them support and strength through numbers will help move these issues forward, as they have a seat on the IBLCE board and it is their responsibility to take the lead in education issues for lactation consultants. Yes, it costs money. But remember, becoming a professional ANYTHING costs money. You are making a commitment to a career. Two or four years of college, trade school, cosmetology school, anything, costs money. Don't expect this to come free. You don't deserve to be a professional if you expect it to. While the long hours of pathways A and B, primary pathways continue to exist, I also strongly encourage you to add supplemental pathways G and H to your preparations. In fact, I would go so far as to say I think they should be required parts of the application process, but I have always been pretty tough when it comes to education! Yes, they reduce your practice hours, but more importantly, they offer invaluable preparation in terms of academic preparation and hands on experience you simply cannot receive otherwise. This is critical --every other allied health care profession demands this, and if we as IBCLCs want to be accepted by the medical community, this has to happen too. There is at least one academic program for IBCLC students, at the University of California at San Diego. But how many people can give up their family life and commit two years to that? Perhaps one focus of ILCA's education work needs to focus on the need to establish lactation programs at community colleges known for strong nursing programs and who intern their students at lactation-friendly hospitals. Approach local ILCA affiliates to encourage interest in this kind of program. Maybe you'll find someone looking for a challenge. Again, ecouraging this vocally, call it lobbying, could make it happen. Do nothing, and nothing will happen; this I can guarantee you. IBLCE and ILCA cannot effectively grow our profession and serve the hundreds of women who want to help mothers and babies if they do not know how you are feeling. Rather than lamenting how long it takes, and how hopeless it is, you CAN advocate for change, and I strongly encourage you to do it. Barbara M. Ash, MA, IBCLC Former Assistant Executive Director IBLCE *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html