"How are we certifying lactation consultants (actually she
may not be certified, I realize, just calling herself a lactation
consultant)."

I think this is one of the big things the public needs to be educated about, Jack, to become proper consumers of this service.  People who are lc, or even LC, are only people who give mothers advice on breastfeeding.  While many, many, many of these people have current information, those initials do not give a guarantee of current information, correct information or even a totally breastfeeding friendly attitude.  After all, people who teach the Ezzo method could call themselves lactation consultants, too.  

In terms of initials, only with the initials CLC, IBCLC, can one infer that her 
consultant is operating from a base of recent knowledge, and even then one
 is assuming that the provider has kept current since certification. 

Chosing an lc, LC, CLC, IBCLC, LLL, Peer Counselor, whatever, from a 
phone book, or from a list of self-advertisers, is the same as chosing a 
chiropractor, or a dentist, or an OB or Pedi from one of those sources.  
Even if you don't chose, and are assigned to one, it is no guarantee that 
they will be in synch with your style, or sympathetic to your needs.

Hopefully, anyone who would be a lactation consultant, professionally or 
otherwise, would be caring, careful and current, but "it ain't necessarily 
so."

Sincerely,  Chanita, San Francisco