Dear all:

The reason why I do not favor a "lesser credential" is that I feel we would be duplicating the efforts 
of many who have come before and have a far better infrastructure for providing this type of care 
than the more clinical IBCLC role.  

The "lesser credential" in reality is a "peer-counselor".  There has been TONS of research on this in 
developing countries and in the United States.  I have a huge document that I tried to share with 
Liz Lange's marketing director when she asked me to "prove that breastfeeding was best" called 
"Quantifying the Benefits of Breastfeeding:  A Summary of the Evidence." that is about 150 pages 
of summaries of studies and conclusions about the overall results.  We know peer-counseling 
works.  

We also know that there are plenty of organizations that do this well.  Rather than reinventing the 
wheel for a "lesser credential" we should work with these organizations that have a much wider 
broad base of support than we have to "upgrade" their counselors.  The reason why this makes 
sense is that they can provide all of the counseling skills that may be a little more foreign to some 
of us that come from a clinical background.  A little fine tuning to develop a "peer counselor" 
program that works well with the sophisticated care with IBCLCs would be an excellent bridge.  
Furthermore, this would eliminate the confusion of many people who get confused about all the 
nonIBCLCs who have gone through short courses and present themselves as LCs.  A good peer-
counselor would be labeled as such.

Secondly, I totally value the role of the front line RNs who work in the hospital.  They deal with the 
initiation of breastfeeding under conditions that I would find intolerable.  I don't have the patience 
to work through all the policies and would never have the ability to tear myself away from a client 
that needed me because I had to see 10 more that day.  

Nevertheless, this is where I have to point out that this is but one small window in a woman's 
breastfeeding relationship.  I work on the problems that occur after the woman leaves the hospital 
all the way through weaning.  While we certainly have an insufficient number of IBCLCs in the 
hospital we have an even bigger dearth of IBCLCs to help women once they get home.  We have to 
stop thinking about breastfeeding as an event that happens in the hospital and more as a process 
that continues for a good time afterwards.  There is no one else, not the pediatrician, not the 
nurse practitioner, not the obstetrician, who will have the time to sit through entire feedings from 
start to finish in today's medical climate.  Can you imagine them spending an hour and a half 
watching the feeding, doing a pre and a post feeding weight check, in instances when mom is 
supplementing, watching the pump and whether her poor nipples and areolas turn into sausages 
because the pump companies have not fully grasped that women are not one size (or three size) 
fits all?  There is a gap between these practitioners that needs to be filled.  We not only need to 
recruit for the hospital environment, but also for the home environment.  I mentioned before that 
in Manhattan we are now considered something akin to personal trainers.  And maybe that is not 
such a bad thing.

This is why I think it is a travesty to consider the IBCLC an "Add-on"  You would not think of an RD 
as an "Add-on".  You would not think of a psychologist as an "Add-on" profession.  You would not 
consider an occupational therapist as an "Add-on" profession.  By considering our profession an 
"Add-on" it trivializes the importance of women being able to get solid clinical help while 
breastfeeding.  This is what I consider to be one of the main problems for women trying to 
breastfeed in our modern society.  They are told be pediatricians that nipple pain is in their heads, 
they are told by the breastfeeding books that it should just happen "naturally", they are told that 
they should get advice from mothers, sisters, friends who have all grown up in a culture that has 
only recently regained its sense of value in breastfeeding.  Many of those mothers, sisters, friends 
may have been luck and have no idea how to help or the "do or die" type that may not empathize 
with the mother that has more difficulty handling the problems.  

Far from considering the IBCLC as an add on, I think we should work hard to have it been seen as 
a full profession in its own right.  Not just for our own sake, but for the mothers we are helping.

Best regards, Susan Burger

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html