My I sure seem to have pushed some buttons with my comments!  I
certainly didn't intend to.  First let me say that if we can't discuss
this issue of valid credentialing on this list, then where does that
leave us?  We must first identify a problem before we can begin to think
of solutions or improvements for it.  My guess is that this issue (of
underqualified people sitting for the exam) is one of the reasons the
IBLCE is considering a tiered credentialing system.  That's just a guess
and it may not be, but I doubt that this is the only area this problem
is coming up.  

I was reporting what I and other IBCLC's in my area are seeing and
saying.  I do not have proof of anyone specifically as Jan requests,
though you can be sure I will keep my eyes and ears open!  In the past,
I heard a few things I probably could have looked into more deeply, but
I'm not one to go chasing after details or reporting people.  At the
time, I had all I could do to keep my head above water in my job.  I
certainly didn't need to make any enemies!  Since then, I have heard
more complaints from other IBCLC's so I think the problem wasn't just an
isolated case or two.  As for the question about how it would even be
possible to ensure that IBCLC's give appropriate advice, of course there
is no way to ensure such a thing.  Just as there is no way to ensure
doctors won't tell moms to stop breastfeeding if they have to take
Tylenol!  In fact, there may be no way at all of fixing the problem I
identified.  We all probably know some doctors who are wonderful with
people and who genuinely care about them and others who just went into
medicine for the power and the money.  Both can give good care.  But the
insurance for that is that all doctors have to go through a residency.
Likewise, all nurses have to do clinicals during their training.  In
both cases, this is experience gained under supervision, not on one's
own.  What if a doctor were allowed to fill out a paper verifying his
clinical experience?  Would some find ways to "pad" their experience in
order to complete the requirement?  You can bet on it.  

That's all I'm saying.  Sure a manager has to sign the form, but what if
the manager has a mandate from on high that there must be an IBCLC in
that position and there was no one else?  Would she be willing to fudge?
(Oh, I didn't realize ALL the hours had to be spent with just
breastfeeding moms.) Please don't flame me.  I don't mean to cast
aspersions, but when breastfeeding is just a job and not your passion,
things may look a little different to you.  I don't doubt a
less-experienced, passionate IBCLC will go after the experience and
education to fill in the blanks.  But what about the one for whom it is
just a requirement of their job?  

I see this as growing pains.  We are bound to experience them and have
to deal with them.  I don't have all the answers but I certainly think
it is worth asking the questions.  I would just like to be sure that the
IBCLC I worked so long and hard to attain and keep will continue to be
the definitive gold standard for a lactation professional. 

Marsha

~~~~~~~~~~~~~~~~~~~~~~~Marsha Glass RN, BSN, IBCLC~~~~~~~~~~~~~~~~~~~~~
Mothers have as powerful an influence over the welfare of future
generations as all other earthly causes combined.
~~~~~~~~~~~~~~~~~~~~~~~~~~John S. C. Abbot~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
  

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