Dear Friends:
    Barbara Wilson-Clay makes an excellent point. The fundamental education of our profession needs to be upgraded.
    I started calling myself a LC because I loved working with breastfeeding mothers, was interested in everything I could find written about breastfeeding, read and went to conferences and had initiative about trying things and being proactive.I became the person on the unit that folks asked about breastfeeding as a result. By virtue of being an RN (and all the other factors), I was able to gain experience and hours and take the exam. However my basic education in lactation has been bits and pieces coming from here and there. There was not a formal course of study at the baccalaureate level.
    Experience, an open mind, and a loving heart took me up in levels of competance and confidence. However, that isn't enough.
    Just think of all the skills that LCs need: counseling,critical thinking, assessment, planning, strategizing, and evaluation. We also need knowledge of birth and its associated technologies, psychology,sociology, anthropology, infant development, anatomy and physiology of suck and swallow, lactation management in all sorts of situations, how women learn, how families interact, education theories,ethics, and more that I can't think of just now. There are many disciplines that all intersect in the lactation field.
    This knowledge is not something that can be picked up on the fly; although an apprenticeship is a valuable adjunct to the necessary learning.
    Spending two days at a Wolf and Glass seminar blew me away. There was such an organized presentation of the anatomy of suck and swallow in a detailed, evidence-based fashion that I have never seen in lactation texts. From that, W &G went on to build on that foundation and taught some assessment skills and tools, some problems and some strategies. Not that they are the only practitioners we can learn from nor am I qualified to practice what they have taught. (I can provide better assessments now than before, and am referring more to OT/ SLPs.)
    However, that presentation made me see how LCs need a larger and more comprehensive foundation for our practice. We have moved beyond the training that one needs to be a peer counselor; we have learned enough to realize how much we don't know.
    warmly,

Nikki Lee RN, MS, Mother of 2, IBCLC, CIMI, CCE

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