Dear all:

Thanks to Gonneke and my husband, I have thought of a variety of ways in which many of us 
might still be able to continue to practice.  My husband pointed out, "you seem to be considering 
yourself a health care pracitioner".  And indeed, I checked the IBCLE website and they do state that 
IBCLCs are considered "health care practitioners'.  But there is no other health care pracitioner that 
is not allowed to contradict another health care practitioner in a professional and colleagial 
manner.  I really see no difference between what was mislabeled a "lower level credential" that can 
be misused by desparate hospital administrations to pay less for training and for professional 
services and what should have been an adjunct profession of equal skills in different areas of 
"counseling" and the IBCLC.  In fact, I think a peer counselor (as many of our dear colleagues in 
LLL have pointed out) will have more ability to provide information to mothers if the scope of 
practice remains as is.

But, my husband pointed out that in the United States, that food and agriculture is far less 
regulated.  So, he started thinking that if we sold ourselves and "human dairy facilitators" those of 
us who must work in the United States would be able to place the entire profession under a far 
more lenient regulatory situation.  We might even be able to apply for subsidies along the lines of 
dairy farmers.  We could lobby for protectionist legislation.  Why should Norway have the corner 
on nonpasteurized fresh human milk when the US has more women that could produce a surplus 
that would be dumped on those poor African women that might have HIV?

I'm also thinking (seriously) about marketing myself as a "Personal Breastfeeding Trainer".  
Definitely not kidding.  There are so many personal trainers in Manhattan that it might even yield a 
higher income than a measly IBCLC.  Now if I could market myself as a "Personal Breastfeeding 
Trianer to the Stars" (which would actually be easy to do if I didn't have this serious problem with a 
hyperactive gag reflex --- Cathy Genna can you help me out on this one?) I'd actually make a 
decent enough living that I might be able to move out of my rent stabilized one bedroom 
apartment.

The more I think about this the more I become totally serious about the idea of figuring out how 
personal trainers are regulated and how to develop a new profession that will help women for 
long-term breastfeeding in a nonmedicalized manner.  Restructuring the hospital environment in 
the United States is impossible right now given the current state of health insurance and hospital 
staffing.  Since 1999 when I had my son, I am seeing a serious decline in the abilty of in-hospital 
staff to provide adequate care, however well meaning and well intentioned they are.  More and 
more I get complaints about how women were not able to see the lactation consultant or if they 
did, the poor lactation consultant had such a workload that she was only able to spend a few 
minutes with the woman.

Most of what we provide is not medical at all.  In fact, none of it is.  It is listening, comforting, 
evaluting how to get mom to feel more comfortable and referring (when one is lucky enough to 
have such professionals available) to breastfeeding medicine speicialists who actually know 
something about breastfeeding medicine. I am lucky in that I have one trusted breastfeeding 
medicine specialist that I can call on a regular basis and another realtively new to me specialist  
that I am hoping to get to know better. 

Best regards, Susan E. Burger

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