Barbara Ash's post said it all.
Here in Israel, we have so many of the same problems that most of you
are voicing, which means that there is an evolution of the profession
which is not going in the direction that the original founders might
have wished. Soon, only hospital nurses will be able to sit the exam,
which means that the moms who are experiencing problems after the first
few days will not really have anywhere to turn for solid professional
help. La Leche League Leaders will not be able to handle the train
wrecks. If I remember correctly, LLL's are only allowed to provide
INFORMATION and not really hands on help. LLL should prepare for this
problem if only hospital nurses are certified.
The fact that so many of us come from a wide range of professions has
added many facets to the way the profession has evolved in the last 20
years. I would say that my teaching background has helped me to pass on
the wealth of information that I have gathered, from conferences,
Lactnet, and experience with mothers. Teaching is no less important in
this profession, and just as we have to learn to assess milk transfer,
if we are teaching, we have to assess information transfer to make sure
that our students/mothers will pass on/process the information
correctly. The exam does not measure these skills. Social work,
psychology, LLL background has given us counseling skills which are so
valuable.
Being a non-nurse in a huge institution has so many advantages that I
could spend days writing about them. Many institutions would not even
think of hiring an IBCLC who is not a nurse. One of my hugest problems
in this is that I feel that my loyalty is to the moms, and not to the
institution, and I will fight for the moms where my nurse colleagues
would never dare cross lines that I cross ( sometimes I have overdone
it, I admit).
I have created a program in my hospital where students who have
finished a 60 hour course can come and do clinical hours with me in the
hospital setting. I presented it to the hospital as a way to help the
hospital help moms, but the truth is that it is for them to have a way
to get hours, albeit experience in the first 3 days. I chose the crème
de la crème of the students. I worked with them for the first 20 hours,
and am available for help when they need it. When they feel ready, they
can work whenever they want, on their own. The nursing staff loves
them, and the moms are so happy to have extra help which I cannot
provide.( I am the only IBCLC in a hospital with 9000 births per year,
95% epidural rates, and 23% c-section rates.) I meet with the students
once a month to discuss various issues, cases, etc and I am sending them
interesting things via e-mail all the time. I even let them teach in a
one day course in the nursing school, to have the experience of teaching
in an institutional setting. The students pay a fee for this course,
not to me, but to a breastfeeding fund in the hospital.
They are seeing amazing cases which they may never have seen otherwise.
They are seeing the problems in hospitals so that when they see moms,
they will understand where they are coming from. I think that this
program will produce the last group of NN ( non-nurse) IBCLC's. Why
can't this be done in other places? I would like to get a place for
these students to do clinicals in the well-baby clinics. Some have
volunteered, but I am not sure that this would count as clinical hours
as they are not supervised by another IBCLC on premises.
Lactation consulting is a passion, not just a profession. The current
method of being certified will make it just a profession, without the
passion. We have to think of how to get more NN's into this profession.
Otherwise, the moms and babies will lose out in the end. What will
happen is that those "3 day wonders" will take over helping moms outside
of the hospital setting, and we all know what that means. I already
hear students saying that they can start working and do not need the
IBCLC title, and believe me, mothers really do not know the difference.
Don't let that happen, those of you who are making the rules!!
Esther Grunis, IBCLC, who had a wonderful visitor yesterday in the
hospital. Ayelet, IBCLC from NY came and shared stories and cases with
me and taught moms using the Rebecca Glover flip-the-nipple latch. You
New Yorkers are lucky to have her there!! She is great!!
Lis Maternity Hospital
Tel Aviv, Israel
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