Mary writes about the need of poor women to receive lactation help.  Given
the cost benefits to the community at large,  (see USDA paper by J Wiemer,
2001 in archives) it makes no sense for our profession to take a scatter gun
approach to serving the needs of people without health insurance or the
money to pay an LC.  Doing so actually perpetuates the lack of access to
care of women who need the help because it is so inconsistently available.

We are all personally available to family, neighbors and friends, and I
don't know a working IBCLC who fails to do this, along with some pro bono
work that involves strangers.  The bigger picture requires organizing to
make sure that the help is SYSTEMATICALLY available and doesn't have to
depend upon charitable impulse or getting lucky finding someone who is able
to work for free.  I am a working person, and my income pays for my family's
needs -- esp. the education of my girls, so I make no apologies for
expecting to be paid.

Organizing to make sure the lactation help is universally available means
that we use our local professional affiliates to lobby for IBCLCs in
hospitals, WIC clinics, and to push other health care providers to become
better educated about lactation support.  In Austin, thanks to a very active
Healthy Mothers Healthy Babies coalition (whose sole focus has always been
breastfeeding) we all worked to create and sustain  Moms Place, a low-income
clinic to
provide IBCLC services.  It is now expanding into a training facility and
mentors students who are seeking clinical experience.  I stipulated in
advance as we organized the Mothers Milk Bank here that my participation in
the project was contingent upon two things:  That there would always be a
seat on the Board of Directors filled by an IBCLC and that when we could
hire staff, there would be a requirement that that person be IBCLC.  So
there are some people who have decent jobs because of this approach, and
there is a way for a mom in our city to get good LC help for free on a
regular basis.  I've also thrown fits over replacing IBCLCs with Peer
Counselors as a cost savings move.  The peer counselors don't make a living
wage, the LC loses her job and leaves the profession, and the consumer
doesn't get the quality of help some of them require to transition babies to
normal feeding.  Ultimately no one wins if we don't acknowledge the issue of
professionalism.  As women, we often undervalue the worth of our work.
That's crazy in the face of the effort, intelligence, time and committment
our work requires.



Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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