I want to compliment Barbara on this letter. The points made are valid, and
the discussion is necessary to have, I believe. Thank you Barbara. Kathleen
Kathleen Bruce RN IBCLC
Independent consultant:
Lactation Resources of Vermont, Medela, Inc. Listowner Lactnet listserv
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Date: Sun, 14 Aug 2005 22:22:45 EDT
From: Barbara Ash <[log in to unmask]>
Subject: too many hours required for certification
Dear Lactnetters,
I recently posted this message on IBCLC2B, a listserv for aspiring IBCLCs.
Many of them are frustrated, discouraged, or have just given up in ever
being able to qualify to sit the exam. Among those are non-RNs, midwives,
doulas, and others who do care about and support breastfeeding others. Some
discussion has been generated by this letter, and I am wondering what you
think.
Dear Future IBCLCs,
Everything I am about to say here is my personal opinion. It should be
read as such, and in no way speaks for my past or present employers' views
on any of the following subjects.
I strongly encourage all of you who are looking at the 2500 -4000 hours of
supervised practice hours as hopeless in terms of every becoming an IBCLC to
write to the new executive director of the IBLCE (check the website for her
name and address) and the Chairman of the IBLCE Board (Dr. Wendy Brodribb,
send it to the Falls Church address and she will get it) and explain to
them if you feel it is unfair to you to deprive you of the opportunity to
become IBCLCs within a reasonable amount of time when you have so much to
offer. RN's do not necessarily make the best IBCLCs, and the data used to
base the 2500 and 4000 hour requirement is more than 20 years old. It is
time, I believe, and perhaps you do too, for a new study to reassess how
many supervised practice hours and lactation specific and general medical
education hours it REALLY takes educated, intelligent women to become
competent, entry-level IBCLCs.
Did you know that number of hours required, specifically the 4000 hours,
can be accumulated over an indefinite time period? This means that a nurse
can count back 20+ years and count post-partum ward hours she did when
doctors were still recommending nipple scrubbing with toothbrushes, and she
was telling mothers to nurse 3 minutes a side. Those hours were
supervised and are valid.
Even if a nurse has never stepped beyond the post-partum floor, and every
hour of the 4000 is there, and she has never worked with an infant more
than 5 days old, she has qualified to sit the exam. And any hours that are
that old are very difficult to verify. Yet, they count as valid hours,
while hours you spend as doulas, midwives and in other positions do not
count because they are not "supervised". This needs to be addressed to
make the process more fair for everyone. How this can be done, I am not
sure, but I am sure it needs to be addressed.
The 3 day and one-week courses with no supervised practice hours and a
non-psychometrically valid exam do not truly give you the credential or
experience or knowledge you need to become paraprofessionals. They
certainly have value for some students, and are excellent orientation
courses. You can learn just as much, if not more, however, through
independent and group study of Riordan, Lawrence, and the suggested reading
list for the IBCLE exam, attending conferences, and shadowing with IBCLCs.
A one-week butt in the seat course is not the answer to 'certification' and
a medically recognized credential.
Five years of La Leche League Leadership comes very close to preparing you
for entry-level IBCLC, because you work with a variety of ages of infants,
but still it is not complete because LLLI's rarely see NICU babies, premies,
or special circumstances babies, but not everyone is cut out to be a LLLL.
La Leche Leage Leadership is not simply breastfeeding, it is a way of life,
a theory of parenting that includes lifestyle choices other than
breastfeeding.
It is unethical to become and LLLI, nor does LLLL want potential women who
are "using" LLLI as a pathway to IBCLC-dom.
I wonder why Pathway F has been temporarily discontinued. It was a valid
program that was clearly working. When will the analysis of the data be
completed? Read carefully the newly added "news" and "pathway F"
paragraphs on the
IBLCE website that talk about our credential as an "add on" credential.
What does this mean to you? Does it mean that first you do something else
like become an RN, RD, or MD, and throw this IBCLC on for the heck of it?
Does it
mean to you that our profession is discredited? Does it infer, to you,
that
being a professional lactation consultant is not a real, valid allied
health care profession that doesn't deserve to stand alone? When I read
this, I immediately felt devalued. Do you aspire to be an IBCLC and
nothing else?
Do
you want a two year AA degree in lactation consulting that would offer you
a standardized program, supervised practice hours, and the opportunity to
sit the exam at the end of your degree program, much like other
paraprofessionals (e.g., respiratory therapists, dental hygenists, etc.)?
If any of these issues mean something to you, express your feelings to
IBLCE, become ILCA members, and inform the ILCA leadership as well. You
don't have to be an IBCLC to be an ILCA member, and your voice counts.
ILCA represents all of us, giving them support and strength through numbers
will help move these issues forward, as they have a seat on the IBLCE board
and it is their responsibility to take the lead in education issues for
lactation consultants. Yes, it costs money. But remember, becoming a
professional ANYTHING costs money. You are making a commitment to a
career. Two or four years of college, trade school, cosmetology school,
anything, costs money. Don't expect this to come free.
You
don't deserve to be a professional if you expect it to.
While the long hours of pathways A and B, primary pathways continue to
exist, I also strongly encourage you to add supplemental pathways G and H
to your preparations. In fact, I would go so far as to say I think they
should be required parts of the application process, but I have always been
pretty tough when it comes to education! Yes, they reduce your practice
hours, but more importantly, they offer invaluable preparation in terms of
academic preparation and hands on experience you simply cannot receive
otherwise.
This is
critical --every other allied health care profession demands this, and if
we as IBCLCs want to be accepted by the medical community, this has to
happen too.
There is at least one academic program for IBCLC students, at the University
of California at San Diego. But how many people can give up their family
life and commit two years to that? Perhaps one focus of ILCA's education
work needs to focus on the need to establish lactation programs at
community colleges known for strong nursing programs and who intern their
students at lactation-friendly hospitals. Approach local ILCA affiliates
to encourage interest in this kind of program. Maybe you'll find someone
looking for a challenge.
Again, ecouraging this vocally, call it lobbying, could make it happen. Do
nothing, and nothing will happen; this I can guarantee you.
IBLCE and ILCA cannot effectively grow our profession and serve the hundreds
of women who want to help mothers and babies if they do not know how you
are feeling. Rather than lamenting how long it takes, and how hopeless it
is, you CAN advocate for change, and I strongly encourage you to do it.
Barbara M. Ash, MA, IBCLC
Former Assistant Executive Director
IBLCE
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