I am late to this conversation because I don't get to read Lactnet on
the weekends but do want to join in.  Great post, Jaye; thanks for that.
I think I want to say off the top that Evi hit the nail on the head when
she said this, IMO:

<<IBLCE is working to find its way - this is a totally new profession,
twenty + years is nothing.>>

That's the problem in a nutshell, IMO.  We are still new, people!  Babes
in the (professional) woods.  I often say to others: imagine the
*pediatric, nursing, pick-one-whatever* profession TWENTY+ YEARS after
the invention of the profession, or their first-ever board exam.  Think
about it! What were the average pediatricians like, 20 years out?
Perhaps I'm wrong but I think it's safe to say that their profession has
come a long way since their early days. The AAP is 78 years old.

Evi was right, this is going to take time.  We, in the meanwhile, are in
the middle of the messy muck, trying to birth a profession.  We think
it's already been born because we all feel keenly - I know I do - that
the pioneers came *before* us - the Linda Smiths, etc, of the field. And
they did! Goodness knows that.  We don't attach the label "pioneers" to
anyone else in the field and I'm not proposing that we do but looked at
from a longer perspective, every single IBCLC out there is also a
pioneer in this field, because professionally speaking, we're still in
labor.

What I'm saying is I don't think there are any shortcuts; this is going
to take more time to fix than any of us have the patience for.  Long
term what I see is a full four-year college degree program, followed by
supervised internship or practicum as Pat Lindsey just said in another
post.

What do our clients do in the interim? To get caught in the middle while
we try to figure out how to train ourselves is not fair to them, I know.
I think the first thing is to stiffen the substantiation of the hours
accrued to sit for the exam.  That, basically, is what we're most upset
about, and what is most damaging to an LC's competency - that the hours
she submitted in order to qualify to sit for the exam did NOT, in fact,
adequately prepare her to be a good IBCLC.  So as Jaye said we need to
discuss this, get creative, brainstorm ideas.  IBLCE is probably paying
attention, after all (:::waves to any lurking IBLCE board
members/staff:::) So here's one idea: the hours have to come from a
variety of settings and/or ages of babies, i.e, not just in a hospital
or just from your LLL group.  What frightens me is the IBCLC that has
never seen any breastfeeding past the first 48 hours - and what
frightened me when I was a newly-minted IBCLC was the stuff that *I* had
not yet seen in my experience as an LLL Leader.  So, what if
IBCLC-wannabes had to substantiate that their clinical hours came from a
variety of mother-baby dyads in a variety of settings and (very
importantly IMO) at a variety of ages/stages of lactation?  Such a
requirement would not be popular or easy to meet but it would help, IMO.
At the very least it would get the nurses talking to the mother-support
group folks and vice versa.  And yes, it would make for better IBCLCs.

Broaden and further specify the clinical hours needed to sit for the
exam, I say. And toughen the substantiation of said hours. That's my
$.02....


Regina M. Roig-Romero, BS IBCLC 
Senior Lactation Consultant 
Miami-Dade County Health Dept WIC/Nutrition 
Breastfeeding Program 
7785 NW 48 ST, Suite 300 
Miami FL 33166 

(786) 336-1333 x162 
(786) 336-1345 fax 
(786) 336-1336 Breastfeeding Helpline 

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