Gonneke wrote,
> Dear friends,
>
> I wonder if this really is what we need to want. Perhaps we should not want IBCLC to be within the health care system. Perhaps breastfeeding and human lactation are better of if not tended to as a health care issue.

> It opens the possibility to work with lactation as a physiologic relation issue rather than a medical issue.
You know, this thought has occured to me more than once. Breastfeeding 
education is directed at nurses and we try to bring physicians into 
these programs, but I am thinking more and more that many of the 
underlying issues are closer to social services than to health care. Is 
that because I'm not an RN and have trouble with biochem? LOL. It could 
be that my background in women's studies colours my picture of what is 
going on, but I often feel like our big challenges have more to do with 
women's disempowerment which results in them feeling forced to live in 
ways more appropriate to men -- in other words, they've fallen into a 
reverse trap because of the same gender issues. It used to be that 
middle-class white women didn't have any other choice but to stay home 
and raise as many children as their husbands wanted; now to remain in 
the middle class they don't have any other choice than to adopt a 
careerist attitude. The balance of having as much / only as much of the 
work we want, and as many / only as many of the children we want isn't 
really much closer.

Is it a danger when we make this a health issue, about risks and 
evidence, rather than a women's issue? I find that women who feel 
supported and empowered have a completely different experience of their 
bodies and their babies than those who don't. And this is true 
regardless of how good or bad the baby's latch is -- although it 
certainly relates to how good or bad they feel about birthing, 
breastfeeding, etc.

If this is true, we should be emphasizing the "counselling" function of 
IBCLCs, and finding a way to ensure that "soft skills" like empathetic 
communication become an explicit, significant, even primary element of 
our education and accreditation.

Jo-Anne Elder-Gomes,
speaking from the privileged position of someone who can work, mostly, 
at home, and as a result doesn't need to pay for most of the things most 
other moms do.

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