Dear all:

In response to Lea's post, I want to make it clear that there has been a CHANGE in what is being told to CLCs recently in our area.  

First, I have a few questions. Has our culture changed to such a point that now people expect the instant gratification of becoming a professional in a mere five days?  Has our culture changed to such a point that people now expect the instant gratification of becoming a professional with no supervised training?  This reminds me of what my sister goes through in the continuation high school where she teaches.  Her school is the last chance for a high school diploma.  Many of the teenagers and young adults she works with have been shuffled through classes where credits were given away.  Her class is a big shock to many because it is the first time they have been asked to actually WORK.  

Furthermore, most health and wellness care professions do require far more training than a five day course without supervised practice.  How would you feel if your nurse practitioner or medical doctor had five days of lecture and never went through a clinical mentoring process?  How would you feel if your doctor of osteopathy too a five day course and never went through a clinical mentoring process?  How would you feel if your physical therapist, merely took a five day online course and no one actually supervised their techniques?  

I know that many are concerned about the course work for the IBCLC, but I actually think the background coursework is MINIMAL compared to many similar programs such as becoming a physical therapist, a homeopath, or a psychotherapist through the social work pathway. I would argue for an even broader and more in depth background for becoming a clinical practitioner.  The BEST IBCLCs I know do not come from a medical background, but have still pursued additional educational opportunities to enhance their understanding.  To date the BEST IBCLCs have a background in nutrition, acting, the law, and one rogue IBCLC who was a customs agent.  These IBCLCs are STILL pursuing additional knowledge.  They are unafraid of learning new things.  The issue is not learning new things, but availability of training to learn these new things. They KNOW that it takes hard work to be a good lactation consultant and that there are no shortcuts to providing skilled services to mothers.

In the past, the CLCs who finished the 5-day course reported that they were ENCOURAGED to pursue the IBCLC and it was a reasonable base (albeit some of the suggestions were unrealistic to implement in real life) for beginning the process for becoming an IBCLC.  We have many IBCLCs who were CLCs among our members and CLCs who are pursuing the IBCLC.  As I mentioned, many NYLCA members have reported quite clearly that they were told that the CLC was EXACTLY the same as the IBCLC except it wasn't international.  As I mentioned, a complaint was sent by at least one of our members to the IBLCE and was written up for the course evaluation.  

Just because a document has some facts correct, doesn't mean that the distortions included in that same document are any less real or any less damaging overall -- sometimes such documents are even more damaging because the reader has no way of teasing out what is truth and what is distortion.  How many potential trainees are going to walk away thinking that IBCLCs might have less than 5 days of continuing education?  How many potential trainees are going to walk away thinking that IBCLCs have nothing to offer in terms of supervision?  How many potential trainees are going to dismiss the international certificate in the same way that mothers dismiss the international recommendations to breastfeed to two years and beyond -- that it is merely something for those developing areas of the world that isn't necessary in our industrialized country where we don't have to deal with "those" problems.  


There are many many programs that train people for peer counseling.  Peer counseling has already been proven to be an ESSENTIAL element towards improving breastfeeding rates.  Yet, there are problems where family, friends and even peer counselors are not enough to solve a breastfeeding problem.  I feel every IBCLC should have mentored experience in a peer counseling program. I would argue that peer counselors while may not need the in-depth training that my vision of an ideal IBCLC should have.  La Leche League is EXTREMELY clear about the scope of the role of their leaders. 

One can quibble about the meaning of the term "counselor" or "consultant".  That quibbling however, doesn't provide the consumer -- the trainee who wants to provide good care with the clarity about what you can learn from a course and what you need when you actually provide clinical care.  And YES, IBCLCs do provide clinical care whether we deem it "medical" or not. And YES, IBCLCs need to have sufficient skills to recognize when we need to refer to other practitioners who have in depth skills that we do not have.  In stark contrast to La Leche League, the CLC program never did clearly define their "scope of practice". As I understand, CLCs who went through prior programs in our area were told "you are only allowed to do what you were allowed to do before".  Anyone reading the white paper might interpret the new scope to be "you can do whatever IBCLCs are doing and your training is just as good if not better".  

Among the bulk of the CLCs who are members of NYLCA, I am seeing many who have the same desire as my colleagues who have become excellent IBCLCs to further their education and deepen their experience.  Among those who want the immediate gratification of becoming instantly qualified, I am not seeing the "just as good" and certainly not seeing the "better". 


Sincerely,

Susan E. Burger, MHS, PhD, IBCLC 

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