We are trying to find out if anyone has an existing protocol, policy, job
description or whatever for the following situation.  If not, we may have to
create one.  I would appreciate any input you can give to help us out.


Here is our situation.  We partner with another neighboring hospital which
is smaller and consequently does many less deliveries than we do.  Their
nursery is a level 2.  We have a full level 3 NICU.  Our lactation
department consists of 3 IBCLCs and one CLC who just took the exam.  Our job
description at the larger hospital requires IBCLC or eligible to take in the
year hired.  (We do NOT require that the person also be RN.)  The partner
hospital has 4 persons who have CLE (and no job description at this time).
One is planning to take the exam next year.  In literature covering both
hospitals we have been using the term "lactation specialist" (no caps) to
describe all the persons working specially with breastfeeding dyads.

Ideally, we know that there should only be IBCLCs and our goal is to work in
that direction.  However, the reality is that this will take some time to
achieve.  One of the CLEs only has CNA education beyond high school, but is
very good at helping moms and has been doing most of the lactation help at
that hospital for many years.  With the new requirements for the exam, she
won't be eligible without taking some courses.  When we had a part-time and
a pool position open (and well advertised) recently we only had 4
applicants, 2 of whom withdrew, so we basically only had the 2 we did hire.
Another challenge is the availability of the exam only once a year.  (That's
not your concern, just part of the mix to help you understand where we're
coming from.)

Now to the question we face in the interim.  Is there anything available
that delineates appropriate responsibilities and limitations for those with
less than IBCLC certification giving breastfeeding help in a health care
setting?  Any guidelines for those functioning under the
direction/supervision of an IBCLC?  We are looking to developing job
descriptions for these people.  I have looked at the LN archives, but of
course those are primarily individual opinions and not what my supervisor is
looking for.

Thanks.

Winnie Mading, RNC, IBCLC
Waukesha Memorial Hospital
Waukesha WI


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