LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
"Jennifer Tow, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 13 Feb 2002 23:54:00 EST
Content-Type:
text/plain
Parts/Attachments:
text/plain (156 lines)
Dawn wrote:
<< Edie Eckman wonders about those RNs who give bad advice. The beauty of the
exam is, they won't pass!  (Unless they start studying, and then they're
going to learn about breastfeeding...) >>

I have to disagree with you on this point. Sometimes they do pass and I have
seen it happen. Taking tests, like anything else, is easy for some and
difficult for others, no matter how much you know. Besides, knowing something
doesn't mean you can apply it well. (In high school, I got A's in
calculus--applications?????who knows!) I have seen those who believe what we
know about bf referes only to the ideal situation and rationalize how it
doesn't apply most of the time. To date, the exam criteria do not prevent
those who give bad advice from continuing to do so post certification.

Laurie wrote:
<<Remember there are several pathways to become eligible to sit the exam. I
believe there are 4 components to qualifying status: 1) requirements for
college degrees (or comparable "schooling") which serves to ensure the
candidate has a basic science, humanities, etc foundation. The degree can be
in any number of disciplines.>>

The degree can be in Fine Art--mine is. Frankly, I don't see the particular
degree as that meaningful. This is not b/c I'm defending my particular
situation--for my first two years I was a biology major, so I actually have
the requirements that are now being implemented.

<< 2) There are requirements for c.e. hours in the recent past, which have to
be on lactation, and serves to ensure the candidate has up to date lactation
knowledge;>>

I hope these numbers are going up--30 hours are very few, IMO. This can be
just 4 days at conferences. Is this enough?

<< 3) there are requirements for counseling hours which serves to ensure the
candidate has "real experience with real mothers/babies" >>

With all due respect, these requirements have ensured nothing. It is true
that a Leader only has to have been a Leader for 5 years and not have aquired
any particular number of hours. OTOH, she really isn't going to pass the exam
if that is all she has done. The many Leaders I have known who took the exam
worked very hard to prepare and had been very active Leaders as well. Still,
I think hours should be logged. I actually logged all of my hours as an LLL
b/c I didn't know I didn't have to, but, I also had an equal number of hours
in my job at the hospital, so was way over.  On the other side of this, I
think the system has allowed a good number of RN's to "loosely" log their
hours. I think Leaders tend to seek to fill knowledge gaps--I have not
personally seen this among RN's (not that it hasn't happened), esp when their
gaps are in counseling.

<<and the counseling hours may need to be mentored and specifically logged.>>

I personally think mentoring should be required and I think the idea of
requiring all non-Leaders to attend meetings (where in any way geographically
possible) is wonderful.

<<Re the LLL hours: the 5 years should serve to ensure that those with high
volume or those with low volume of contacts still have enough counseling
hours (along with the other 3 requirements) to take the exam. If a LLLL is
doing really high volume of contacts, she could log them, and conceivably
meet the requirement of counseling hours sooner than 5 yrs, say in 3 years.
Nurses do the same thing. They probably have not specifically logged all of
their hours of counseling bf moms. So they estimate as best they can the
amount of hours they spend working with bf moms and they take the no. of
years they have been doing that and come up with their hours, signed off by a
supervisor who affirms they are being truthful. >>

Until now, there has been no better system, and in all fairness, people
really are playing by the rules, even when estimating high. But, I will say
that it is almost a certainty that the infomation Leaders give in all of
their 5 years (or however many) of Leading is pretty accurate, b/c that is
what she learned. Another HCP working with moms for 5 years may be spending
very little real time on bf, even while working with bf moms and may be far
more likely to rely on inaccurate information, b/c that is what she learned .

Kathy Rubin wrote:
<<I do applaud the recent updates by the IBLCE to include more science
courses in the prerequisites, and to look more closely at the hands-on
documentation. This should help to ensure that the standards to be Certified
as a Lactation Consultant remain high.>>

I agree that the standards need to be high. I wonder, though, why we haven't
looked at the body of existing IBCLCs and considered what really makes us
effective. IMO, the skills a Leader learns should be basic requirements (I do
not mean being a Leader is the only way to attain them). They may be more
ephemeral, but I rely on them a lot, and I do trust LLL/IBCLCs more when
referring blindly b/c counseling skills are not essential to be certified and
I will be more likely to find someone w/good counseling skills in a Leader.

Kathleen wrote:
<<In IBCLC prep, I believe that we need to have an active  clinical component
which teaches new IBCLC to be's how to do the clinical hands-on work, if
there is hands-on work needed, and how to tailor and hone one's consulting
techniques to fit the needs of the client. Mentoring meets this need, but
then there is an issue of how to provide this, and compensate the mentor for
the work done, since it is more work to teach while consulting than it is to
solely consult.  To train and  prepare someone to be a lactation consultant
who can handle a wide variety of complex clinical situations takes a long
time, and cannot be done in a quick way.>>

I agree completely.

Andrea wrote:
<<I also know that these new requirements will make it much harder for
mothers who come from abackground that includes volunteer breastfeeding
counselors. Because of this, I am very fearful for the LC profession as a
whole.>>

I think Leaders are pretty much out of the running, since they will often be
unable to persue the formal education while mothering young children. If I
were in this position right now, I would not choose this as my profession. I
do not rely on my pshycology, biology, chemistry, etc courses to support me
as an LC. Frankly, my background in marketing and advertising and my Leader
experience have been much more useful to me. And, of course, the fact that I
read constantly. I wonder, too, as fewer and fewer Leaders become LC's, will
the an HCP certification/degree/etc become a prerequisite?  Or will it just
become so difficult for non-RN's to practice that we will eventually
disappear and lactation consulting will become just an additional
certification for nurses? The whole idea of lactation consulting as a
university degree program also suggests that many more people will become
LC's, never having had or bf children. How might that impact on the
profession? More medicalized? More theoretical? Less empathic,
mother-to-mother?

Catherine wrote:
<<Now if only we could work this depth of experience into a clinical program
for all LC wanna be's, we'd be a good profession.  And if we could merge the
clinical infant assessment skills and comfort with medical terminology that
the RN/IBCLC's often excell in with the breastfeeding experience of
LLLL/IBCLC's, we will be a strong profession indeed.>>

I agree with this. Unfortunately, what I see is a system that clearly
exhibits a stronger preference for the type of skills an RN might already
possess and much less regard for the skills a Leader might already have. What
I would like to see is a system that values both paths of entry and seeks to
strengthen both by adding the skills of the other, not eliminating one in
favor of the other. I think that this type of action reduces our profession
to a 2-dimensional status and I have to wonder who ultimately benefits. Is it
really the families? Is the actual making of a profession more important than
being the best we can be? I personally prefer to expand rather than diminish
what I am capable of. While I did not learn bf skills from the nurses I
worked with, I did learn a lot about how hospitals and HCPs influence bf
success, I learned a lot of jargon, I learned about how various medical
situations impact bf, all of which improved my skills as an LC. In other
words, I am a much better LC for my experience in a medical environment than
I would be if I had not been there, but what I learned there was gained
quickly and easily by observation--what I learned as a Leader required much
more investment of time and energy and developed the assessment and
counseling skills I find most essential.
Jennifer Tow, IBCLC

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html

ATOM RSS1 RSS2