I am glad that this discussion is taking place and I hear so many wise comments on this subject.  Although I live and work as lacatation consultant in USA, I have been in touch with many breastfeeding supporters from Russia, Ukraine, Belarus and Latvia. I was born and raised in Belarus and I had my first baby there. I found that it is hard to imagine for someone living in this country, how different everything is in other countries. This is true about lactation consultants as well.  There are many of them in Russia, some belong to organization Natural Feeding Consultants of Russia (NFCA), which has own scope of practice and Code of ethics. They are working on their own educational programs. One of the problems is lack of educational literature in Russian. Most of those consultants do not have a medical background ( however many of them have at least 4-5 years of college education in other fields). I met many wonderful women, talented and energetic, hungry for knowledge. Some of them have superb skills: their techniques of breast massages, hand expression and working with multiple problems are amazing. 
 It is almost impossible to take college courses of any kind unless one enrolls into degree program. There are no lactation consultants in maternity hospitals, most nurses and doctors have a very limited knowledge about breastfeeding. And yet, breastfeeding rates in Russia are higher than ours. 
This year 15 candidates from those countries took IBCLC exam (in English). The main purpose was to increase their knowledge and work on establishing a better educational programs for future candidates. The new requirements will close the door for many and many of others. We are talking about a country with over 146 mln people and over 1.7 mln births per year. Those mothers need support and good knowledgeble consultants. All 15 candidates told me how valuable this process was, how much they learned from it. They will become the first IBCLCs in Russia. Last year Theresa Yaroshevich (UKraine) and Sandra Lase (Latvia) became first IBCLC in their countries. It is sad that new requirements will make it impossible or al least will slow down this process for many others that would love to follow them. If we have International certification, we have to think about those who live in other parts of the world and how this decision will affect them.

Maya Bolman RN, IBCLC
IBLCE Coordinator for Russia

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