I will play the devil's advocate here for a moment and give you the Nordic
take on IBCLC's.
The usual response, even among people who are majorly concerned with BF, is
'IB what-did-you-say?!  You mean BF is something people hire consultants
about?  I thought it was just how we fed babies.'
Then we have to explain about the studying, the clinical experience, the
exam, and all that.  I admit to some ambivalence about the idea of another
profession which, as I see it, specializes in one very focused area of my
primary profession, which is midwifery.  Some midwives are more excited
about antenatal care, some about primary health care for women, some about
just plain catching babies, and some like working post partum.  All of us
should be familiar enough with all those areas to be able to pinch-hit there
if need be, in my opinion.  Women progress through all those areas in a
single pregnancy and puerperium, and they should be able to have continuity
of carer, IMO.  That means we need to be very skilled generalists.

My fear about the advent of the IBCLC here is that it will give those
midwives who already would gladly relinquish all their shifts on post
partum, an excuse for staying unskilled in the practical work of supporting
BF.  The IBCLC credential seems unattainable to many Norwegians, if for no
other reason than that the literature is in a foreign language as is the
exam.  So for the time being we are far from flooded with new IBCLCs.  The
National Breastfeeding Center has also arranged courses for health personnel
who work with breastfeeding dyads (and tryads etc.) and are planning to
award a domestic credential as a 'breastfeeding adviser' to those who
complete the requirements for it.  I can't remember what kind of testing, if
any, there will be.  It will be an improvement over today's situation in
terms of education, but I am not so sure if it will be an improvement, to
make breastfeeding such a special area that you need an extra credential.  I
really think *all* professions who work in this area, should have enough
content on BF to make such courses superfluous.  Goodness knows we have
plenty of dyads to learn on and most of us have first hand experience too.

To be honest, my own reason for taking the exam was that 6 of my colleagues
in Oslo were going to, and I couldn't bear the thought of not being one of
the elite few to get the credential here.  I'm sure I broke at least one of
the Ten Commandments there, but that's how it was.

Has anyone ever looked at the relationship between number of IBCLCs per
capita in a country, and BF initiation rates?  Number of IBCLCs and average
BF duration?   Yes, IBCLC is the gold standard for certification processes
leading to a credential in the field of breastfeeding.  In a place like
Norway where BF is not really a field, more of a fact of life, the IBCLC
hasn't made many inroads yet, and our gold standard remains the BF-friendly
society.  That seems elusive at times too.

Rachel Myr, committing heresy in Norway

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