Sorry for the length of this but I am concerned that Lactnet is becoming a forum for comparing qualifications rather than airing real issues of breastfeeding.
Again and again we discuss who is the best qualified to counsel for breastfeeding, and among us who are also childbirth educators, this question also is frequently aired.
The problem is that in most countries, childbirth education and breastfeeding counselling do not stand alone as speciality professions.
When I trained with NCT in the early seventies, we were battling with the attitude that only physiotherapists and midwives/public health nurses could do this work.  Within a few years, the British Department of Health recognized NCT and its training so that many health professionals were coming to courses run by NCT. And many non-medically trained teachers/counsellors were accepted in health institutions.  After all if birth and breastfeeding are not just physical body functions, surely other professional qualifications such as social work, occupational therapy, education, psychology are just as relevant providing they are just the starting point to  training with a recognised organisation.
When I arrived in Israel, in  the mid-seventies, the clock had gone back and again we battled for the rights of multi-disciplinary graduates of recognised overseas training courses.
Eventually, by forming the Israel Childbirth Education Centre we have got to the stage that many health professionals attend our training courses.  However, this still leaves a situation here and  internationally that there is no independent recognised profession that stands alone as childbirth educators/breastfeeding counsellors.This opens the door for unqualified counsellors to jump on the band-wagon - it only take some agressive marketing and a good web-site to promote new gimmicks and most consumers do not  investigate whether the "counsellors in these revolutionary new methods" actually do have certification.

I would never accuse paediatricians/obstetricians/hospital or clinic nurses of being ignorant.  But I am convinced that because of their pressure of work and further study requirements in a much wider field, most of them cannot concentrate their efforts at a high quality level on the issue of education and counselling.  Even those medical personnel who have trained as educators/counsellors have limited time within their day-to-day jobs.

Those of us who work independently can budget our own time.
If I run a childbirth education course for six couples in three different places each week, I know that in two or three months I am going to be called on as a breastfeeding counsellor by a possible 18 couples for home/hospital breastfeeding visits (or other postnatal issues) with continuing telephone contact and possibly another visit before I can consider my job is done with those three groups.  Each home visit can take 1-2 hours and my phone never stops ringing.
However apart from running occasional training workshops or preparing a conference paper or lecture for an outside group, my priority is working to make sure those 18 couples get quality time with me. In order to provide the most updated of information using effective counselling and listening skills, I read journals and professional web-sites, attend conferences and study days and methodology workshops throughout the year, all at my own expense in terms of time and money.
 If I worked in a hospital or clinic, I would reach many more parents and that would please me, but I would not be able to give that intensive time.

Most of the time I work very harmoniously with the health professionals.  They refer parents to me for education and counselling and I refer parents to them for medical opinions.
Of course some HCPs are better and more conscientious than others.  My family doctor has beautiful water-colour paintings of breastfeeding women in her waiting room and when I congratulated her on hanging these pictures instead of calendars sent in by the formula companies, she told me they were painted by her mother-in-law.  There are other physicians who are excellent at diagnosing children`s medical problems but actively sabotage breastfeeding and I honestly don`t understand their agenda.

So we need some tolerance to work together so that all of us in our own way can help parents to prepare for and handle what can be the toughest years of their lives.  The labels and the rivalries just get in the way.

Wendy Blumfield
Israel Childbirth Education Centre
NCT Tutor ANT/BFC

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