There have been two posts today which prompted me to write about the
IBCLC credential.  Frances asks about writing a job description for a
Lactation Coordinator- one who would do home visits to trouble shoot
breastfeeding problems.  And Debbie is a RN who is now seeing her
hospital's breastfeeding mothers, and encountering questions for which
she says she has little experience.  Please do not take the following
comments as a criticism of any of you wonderful people working to help
mothers and babies...

Frances, you mentioned the following:
> At this point we guess the CLE or IBCLC eligible (took class, not finished with
> all homework/clinical time or whatever) is the primary consideration and
>whether person is RD, RN or other health specialty is important but less
>absolute...

I think it is important to point out that there is a VAST difference
between what the CLE and the IBCLC initials represent.  As I understand
it the CLE is a "program completion" certificate.  Meaning that someone
has attended a class, like the five day ULCA course on breastfeeding.
But there is no examination similar to the IBCLC exam involved.

In my community, it is incorrectly assumed that RNs, simply by virtue of
their previous nursing school training, (or perhaps simply because they
nursed children of their own) are adequately trained to see
breastfeeding mothers with problems.  And someone who has CLE after
her(or his)  name is assumed, not only by the public, but by other
health care practitioners, to be FULLY certified as a consultant.  This
is really not the case, considering the fact that IBCLC candidates must
have a minimum of 2500-4000 hours practice working with breastfeeding
mothers as well as numerous continuing education credits relating to
breastfeeding, before they may even be allowed to sit the examination to
"show what they know."  (Then, of course, they must PASS the test!)

Frances, I would urge you to make the IBCLC credential the standard for
your breastfeeding position, if that person will be doing hands-on
breastfeeding assistance.  Even if it will be awhile before someone with
those credentials can be placed into the position, I really feel it is
IMPORTANT for all breastfeeding advocates to make sure mothers and
babies get the very best, including help from the people who have shown
themselves, through quantified examination,  to be adequately
qualified.  I believe this shows proper respect for "Lactation" as an
valid, specialized area of expertise.   The IBCLC is considered
"entry-level qualification.  Debbie, are there any IBCLCs in your area
to whom you can refer your difficult cases?  My guess is that if you
started referring to local IBCLCs, they would be willing to let you
learn from them, at the same time.

 I appreciate your honesty and sincerity when you mentioned that you are
not a certified lactation consultant, and that your knowledge is
limited. I'm concerned, however,  when I hear that, *in spite of a lack
of credentials,* hospitals are going ahead and presenting staff members
as experts.  It seems it not only must be confusing to the patients, but
it also puts you (as the nurse covering the lactation cases) in a bit of
a bind, knowing yourself that you really are not fully trained and
certified.  Would this happen for other health services, such as speech
pathology, dietetics, physical therapy, etc?

I wish you the best.

 Respectfully,
Sue Jacoby, IBCLC
Central California