My experience from being an LLLL to an IBCLC to an RN in different areas of the
country leads me to believe in the eventual "Word of mouth" identification of
qualified individuals.

Currently we have a person who passed the exam after having breastfed her own
for over a year, attended the Georgetown course, offered her services thereafter
as a Lactation Consultant - renting pumps, giving classes, writing literature,
etc.  and used those hours to qualify for the exam - never having worked under a
trained LC.

But - how did the rest of us do it when there were no trained LC's to work under
- by the seat of our pants!  We learned with our patients (I'm talking 1985,
people), and the word got out - who knew and who didn't - and who worked better
with what type of mom.  Let us realize that just as with LLLL, a lot of
personality goes into LC work - and sometimes we "click"and sometimes we don't.
I was always glad to have a co-leader as moms would call the one whose
personality best met her needs.

Right now I am in a quandry as one of the MD's I work with says that Ruth
Lawrence stated NO MD SHOULD TAKE THE IBCLC.  For this reason, she refuses to
take it, even though the insurance company requested the MD's have some sort of
way to identify those who should be paid separately as giving LC services.  The
IBCLC seemed to me the easiest way to identify them.

So - how to identify those people who are qualified?  It will always be a hard
thing to do - hopefully those who are not qualified for specific problems
(relactation, cleft palate) through lack of experience or lack of the
personality required, will refer moms to those who do have these.

Meanwhile, moms will continue to get incorrect info. not only from "LC's" but
also from nurses, MD's, neighbors and friends.  In my class in the hospital I
encourage moms to remember two things:  1)They have great instincts, so follow
THOSE especially if the recommendations given by others don't sound right. 2)
They are their baby's advocate and need to be persisitent if things don't seem
to be going well - even if they need to go to many different sources.

In any service we need: Buyer Beware! - accountant, auto repair, hair dresser or
doctor - we need to be aware of our needs and study the alternatives, not just
go to the nearest or cheapest.

Jeanette (who has been burned by all the above!) Panchula, LLLL,BSW, RN, IBCLC