I guess I have the exact opposite opinion than Jennifer regarding licensure of IBCLC lactation consultants. The purpose of licensing is to protect the public. While we all certainly know licensed health professionals whose poor?practice (especially regarding lactation care and services) certainly does not protect the public, we need to look a little closer at why licensure is so important. Licensure would help advance the profession of lactation consulting, at least in the US by putting the profession on a par with other licensed health care providers. Respect, inclusion in policy making, status, third party reimbursement eligibility, a?stronger voice for improved lactation care, a broader base of job opportunities?are a few of the pros for licensure. With licensure comes a legal responsibility, which means that cooking lavender blossoms in?one's kitchen to smear on sore nipples would probably not be considered appropriate for a licensed health care provider.

The fear of licensing is that another profession will take control and dictate practice parameters. That is why in Massachusetts we have been trying to get legislation passed that would establish a licensing board for LCs only, not have LCs carried under nursing or medicine licensing?boards. In Texas legislation was defeated because physician groups did want want LCs licensed. This is to be expected when other health professions feel challenged on what they consider their own turf, especially if it means money going to someone else. In Vermont, legislation was defeated because it could not be shown that harm would come to patients if LCs were not licensed. Licensing can also be expensive, since licensing boards are funded by the fees collected from those they license. We can learn from all of these defeats and keep up the goal of securing licensing.

Look at the number of posts in Lactnet that describe the frustrations of LCs who practice in hostile hospital environments, who have no say in ridiculous hospital practices, who cannot actually do their job because hospitals insist on feeding their addiction to formula company handouts. Mothers and babies are suffering because?LCs need?a more powerful voice in the care that is delivered to them. Licensing is but one way to step up to the plate?on equal footing, get our message across, improve care, secure good jobs?with adequate reimbursement.

I doubt that the?ILCA conference?is having any specific conference?sessions on these issues, other than special interest group meetings. I think we need to organize state by state, find out what it would take in each state to become licensed and begin our grassroots efforts to secure licensing one state at a time. This can take years, but we owe it to ourselves and those we serve to strive for providing the best care we can.





Marsha Walker, RN, IBCLC
Weston, MA



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