FYI - I wrote Dr Bartick last night. Here is my letter:

Dear Dr Bartick,

I was very sad to hear that UMass Memorial Medical is eliminating all of its RN-IBCLCs, and commend you on your letter, posted on your coalition web page. 

However, may I ask you more about your comments in points #6 and #7? 

·    “Lactation consultants are currently not licensed in any state, so hiring non-RN lactation consultants would mean there is no government oversight or consumer protection for these individuals providing clinical care at your hospital.” 

·    “It is standard of care for hospitals to provide RN-IBCLCs, especially those of equivalent size as UMass Memorial, with a level 3 nursery. Whoever will fulfill the role in the NICU should have experience and training in caring for critically ill preterm infants. By assigning this care to non-licensed personnel without a nursing background is risky for the infant, the mother, and for your institution.”

You clearly highlighted the need for IBCLCs (not CLCs) to provide qualified lactation care, referencing various sources. However, these sources do not infer that the IBCLC should necessarily also be a RN to be adequately qualified. I am curious about why you believe that hospital-based IBCLCs (especially those who might work in level-3 NICUs) should also be RNs? While IBCLCs are not licensed currently, there is most certainly “consumer protection” (through the IBLCE and their Scope of Practice and Disciplinary Procedures, which is accredited by the National Commission for Certifying Agencies). Can non-RN IBCLCs not provide excellent lactation-specific care either alone or in conjunction with RN-IBCLCs?

I fear that your view is echoed by many, and that this severely limits opportunities for IBCLCs to practice and share their passion and skill, and puts an unnecessary cost burden on medical facilities. Of course, until licensure for IBCLCs is instituted, reimbursement for care by non-RN IBCLCs is a problem. I feel that it would be in the best interests of ALL to encourage the use of non-RN IBCLCs – even in hospitals. Perhaps the IBCLC who cares for the extremely fragile babies should be an RN too, but for most other families, an IBCLC does not need to provide nursing care, just lactation care.

There is a large hospital group in the Portland, OR, and Vancouver, WA area, that hires both non-RN IBCLCs and RN-IBCLCs. They have a level-3 NICU. I think that their approach to lactation care is ideal. However – they are the only hospitals to do this, that I know of.

I would appreciate your sharing your reasons for your views with me, as I truly don’t understand.

With the utmost respect,

Fay Bosman, IBCLC
President, Clark County Breastfeeding Coalition, Vancouver, WA
Lactation Consultant, Clark County Mother Nurture

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