Dear All,

My name is Aileen Emerling. I am a newly certified IBCLC.  I have been
following the recent discussion about whether IBCLCs are med professions
with great interest.

In Japan, where I live, until this year all of practicing  IBCLCs also
held other degrees as medical professionals. I am trying to establish
the first private practice here without having the additional MD or CNM
as other credentials as well. In my own case, it is relevant to know
whether the IBCLC is considered as someone who giving medical advice .

I have looked for legal help and used the following documents to help
explain/clarify my situation. The IBCLC Scope of Practice and Education
Guidelines, Standards of Practice for IBCLC Lactation Consultants, and
the Code of Ethics.  I have also referred to the relevant sections in
Core Curriculum for the Lactation Consultant Practice ( See part 10).

Perhaps the questions that are really arising here is "what" defines a
medical professional? Are the terms medical professional and health care
professional interchangeable? Do other medical professionals have a
clear definition of  the role of the IBCLC?

I would love to hear other's feelings about this.

For example, We cannot as IBCLCs diagnose conditions, nor can we script
medicines.
We are part of the allied health team. When we work with a mother baby
dyad our clinical practice includes Assessment, Plan, Implementation,
and Evaluation. (See Standards of Practice)

Additionally,
"Recognize and exercise professional judgement within the limits of
her/his qualifications. This principle includes seeking counsel and
making referrals to appropriate providers.
Unless the IBCLC has other health professional  qualifications and is
legally entitled to act within the parameters of those qualifications,
he or she must keep a clear distinction between the "mechanical"
management of breastfeeding problems and possible medical ramifications"
(Core Curriculum for LC Practice p 520)

My question to all is- do you feel that the mechanical management of
breastfeeding problems constitutes giving practicing medicine or medical
advice?

 "An IBCLC is defined as: "The International Board Certified Lactation
Consultant is a health care professional whose scope of practice
encompasses working collaboratively with primary care providers to
assure appropriate clinical/practical management of breastfeeding and
lactation in order to protect promote and support breastfeeding. Such
practice includes providing education, counseling and clinical/practical
management to allow breastfeeding to be seen as the expected way in
which healthy newborns are to be fed as well as to prevent and solve
breastfeeding problems. Education efforts extend to the community as
well as to breastfeeding families and health care colleagues.
The role of the International Board Certified Lactation Consultant is
dynamic and changes as the theory and practice of breastfeeding support
and lactation management evolve to incorporate research findings and to
adapt to societal needs. Practice is based on the principles outlined in
this document, on the Standards of Practice for IBCLC Lactation
Consultants and on the International Board of Lactation Consultants
Examiners (IBLCE) Code of Ethics" (The International Board Certified
Lactation Consultant: Scope of Practice and Education Guidelines p. 1)

The Scope of Practice can be helpful for us to clearly define what we
are trying to do.  Perhaps sharing this document  will be helpful when
there is a question fo ul;timately- who are we and what are we qualified
to do.

But again if I may come back to my question- do you feel this constitues
practicing medicine or giving medical advice?  Do you feel that a
"medical professional" is different then a "health care professional"

 "Professional Role Competencies
13. Interprets and promotes the role of the IBCLC to consumers,
healthcare professionals, and the community.
14. Develops uses and maintains collaborative relationships with health
care professionals to strengthen the role of the IBCLC." (same citation
p 9)"

For myself these quote above is very relevant, because for those of us
in countries with a small number of IBCLCs, what we do- or do not do,
how effective we are in our own roles, will help to pave the way for
future IBCLCs to be respected and accepted within the medical community.

I apologize that this post is so long.  But I look forward to continuing
discussion on this.  Thanks as always for your support.

Take Care

Aileen Emerling IBCLC
Tokyo Japan

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