I think it is wonderful to see the discussion about how we are certifying
LCs.  We need to continue to explore this and to be open to a future which
may do things very differently.  I was interested in Linda Smith's
comparison with Athletic Trainers.  This profession went from an hour of
coursework to Masters Program in a real short time -- why?  Because sports
have gotten high tech and money is involved. Athletes realized they couldn't
afford to have their livelihoods threatened by well-meaning trainers
practicing their belief systems on them.  Athletes demanded sound management
by well-educated trainers practicing clinically based techniques with firm
grounding in physical therapy, wound healing, probably counseling, etc.

 Its a great analogy for what we do! If only mothers (consumers) would
demand this! If only we valued women's health care and the rights of infants
the way we do these million dollar jocks.  Women  don't value their own
right to care enough or we would have progressed to universal birthing
centers like the hospital K. West described (in the 80's) or like Evergreen.
Women are still reluctant to complain about poor care, or not enough care
("everyone was so nice, I hate to get anyone in trouble.")  And professional
women are still afraid to break the code of being "nice" to complain about
the quality of care being provided in programs in their institutions.

If we are smart, we will work on a university pathway for certifying LCs --
even if it means that the way we currently do things gets phased out of
existance. This would allow for didactic and supervised experiential
training, and result, ultimately in liscensing. Often pioneers get only to
the top of the ridge, and never personally make it to the promised land.
That may be the fate of our generation of LCs.  But if we can collectively
create a way to train the next generation, and make these LCs powerful and
respectable, they can speak up for mothers and babies in a way we perhaps
cannot -- aware as so many of us are, that we are not yet really accepted as
professionals.  And I say again, we would be very smart not to tie the
profession to nursing, but to make it a free standing credential. And to
quit being so dammed apologetic and embrace the idea that we are specialists.

This plan does not mean there won't still be a place for nurses with
lactation knowledge to help mothers in hospitals.  Hopefully nurses'
training will begin to have coursework in lactation at the undergraduate
level.  RNs with the ability to do so should be actively promoting this now.

This plan does not mean that the "barefoot doctors" ie the LLL Leaders and
NMA counselors and the peer counselors won't be important.  They are still
vital in the communities as  mother-to-mother helpers.

What it does mean is that when a mother has a breastfeeding problem which is
outside the realm of the ordinary, she will be able to consult a
practicioner and have a reasonable expectation of a certain level of skill
and professionalism. Just like you would if you hurt your leg and needed to
be able to play in the big game in a week.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html