Jessica and Kay and everyone,
If you will get one of the IBLCE pamphlets about certification you will see
the number of clinical hours required for a candidate to sit the exam are
different depending on his/her education.  Someone with a 4 year college
degree needs 2500 hours, but someone without needs 4000 hours.  That is what
a lot of the discussion is about.  It takes someone working as a volunteer
counselor a looooooooong time to get these hours.
Kay, I agree, I would want YOU helping me with breastfeeding over many people
with lots of degrees, a lot of book learning and who have never nursed and
really don't understand the process.  What I am proposing is that "everyone"
have better experience and have at least a portion of their "hours" working
with other experienced LCs in various areas.  There is so much to be gained
although this would mean you have to take the time, trouble and money to go
to a hospital, clinic, private practice, and support groups to mentor.  What
I have been seeing is that no ONE area gives the LC the complete picture of
breastfeeding and all the potential problems and solutions.  People who work
in clinics have often never helped a newborn latch on.  Those in hospital
nurseries often give poor advice to mothers with babies past the newborn
period.  Volunteer counselors have rarely had the opportunity to work in a
neonatal unit or postpartum unit of a hospital and see the medical
emergencies faced there, also there is a huge volume of mothers --a
completely different population of people who will NEVER go to or call a
volunteer breastfeeding group so you never see certain problems or some
personalities of mothers. I know because I have worked on all sides of this
for many years.
In order to be qualified to be certified I still believe a more well rounded
background needs to be required.  IBLCE could require that applicants spend a
minimum number of hours (20 or 30 hours--just a suggestion) in all settings
that involve lactation . . . prenatal (volunteer groups, prenatal
breastfeeding classes),  perinatal (hospital PP unit--making rounds with a
hospital LC), early weeks (home visits with a Public Health Nurse or LC,
Private LC practice mentoring or observation, support group meetings, PP
phone follow up--done various settings), problems (observation in a NICU unit
of a hospital--see hospitalized or sick moms and babies--private LC office) .
As a friend said "If I were a mother with a baby and needed help, I would
want the person who walked into my room to be REALLY  well qualified and to
have passed a HARD test".  I know people desperately want to take the exam
and dislike how long it takes them to collect the hours, but we are
struggling for recognition, credibility, insurance reimbursement, respect
from other professionals, and we are not going to achieve these things unless
our certified people can live up to high standards.
Lets keep the discussion going.
Jane Bradshaw RN, BSN, IBCLC
Private Practice in Lynchburg, VA
Reserve LLLL
Part-time hospital LC