This is a difficult post for me to write. When I first heard of the
proposal that only IBCLCs be voting members of ILCA, I was crushed and
even angry. Now I am only sad. I mourn on two levels, one level being
personal and the other for the future of not only ILCA but the profession
of lactation consulting. I will address the second first.
One of the biggest obstacles I have had to deal with in breastfeeding is
the difficulties resulting directly from the medicalisation of
childbirth. As a result, I have been watching with dismay the trend to
medicalise breastfeeding. To some degree, it is unavoidable, but I am
often encouraged by threads on Lactnet that recognize the importance of
cultural impacts on a physiological function. By granting a "superior"
status to members holding Board-certification, I fear that this will be a
move towards medicalising breastfeeding counselling. As far as ILCA is
concerned, although this sounds harsh, I'm afraid that Americans and
Canadians have a very parochial attitude. Lactation consultancy may be a
recognized health profession in North America, and well-accepted in very
liberal countries like Australia and New Zealand (and I think all of you
guys are terrific, don't get me wrong!), but in many other places (like
my own little-bitty Israel), we have a very, very long way to go in
persuading our entrenched medical system that there is a new profession
out there. I do understand the rationale behind the proposal, and I agree
with the hope that it will strengthen the profession, but I think that
the move is premature in view of the *world* status of the profession.
Since ILCA by name purports to be an international association, it should
recognize that the world is a much larger place than North America, even
though most of the members are from North America and even though most of
the members are IBCLCs. (To go off on a tangent for a moment, Carol
Ryan's argument that because 80% of ILCA members are IBCLCs, this
justifies the change in voting membership requirement does not make much
sense. How about being married? If 80+% of members are married, why not
limit voting membership requirements only to the married? Or having
breastfed for x years? Or having x number of kids? Sorry about that.)
Now for the personal side. I will never be Board-certified. I will never
ever be able to acquire the number of hours, living in Beer Sheva and
having to work to help support my family. I will never have the
money necessary for the exam or to recertify. And even if the above
all somehow resolved, so what?: Lactation counselling by a
non-nurse will not be recognized as legitimate in the city where I live
in my time (I am 50 years old). The change in member voting eligibility
right now will not only disenfranchise me permanently within ILCA, it
will make my attempts to promote breastfeeding in my area much more
difficult by delegitimizing me. In other words, if I don't have Board
certification, well, I must be a quack. I have already heard this BTW. In
1993 I published a modest pamphlet on breastfeeding in Hebrew, cheap and
easy to understand, no footnotes, no references, strictly a how-to book
to help moms who want to breastfeed. A few years later, I heard from
another Israeli LC that an Israeli IBCLC said to her that I "had no
right" to write a book on breastfeeding. This is the sort of thing that
ILCA wants to foster or encourage? Do you really want to make an
exclusive in-group? You may honestly believe that you will increase the
integrity of the profession, but in my shoes, I see it as opening a real
can of worms. Beware. Very sadly yours, Judy Knopf in Beer Sheva, Israel