This discussion comes up on Lactnet often.  I don't share the belief that
IBCLC qualifies you for any position just because you have earned IBCLC.  I
would think it is very important to have multiple qualifications for many
jobs, not just LC.  Why would a hospital position be any different?  There
are certain positions in a hospital that require more than "IBCLC" to be
qualified to perform, even if it is a job related to breastfeeding.  I try to
understand why as LC's we assume the credential should open all doors related
to breastfeeding.   Does that mean that 'only' RN IBCLCs should be employed
in hospitals?  No.  But it does mean that respecting the different levels of
knowledge and skills are important.  There may be some hospital positions
where RN is not as necessary, but I know that in many hospitals positions are
multi tasked . . and being IBCLC does not mean you can draw blood or start an
IV. . .and an RN can do those things as well as LC related work.  That means
one pay for two jobs.  I don't think this is only about respect for the
field, I think it is a dual issue. .. and the other part is money.  I would
like LC's to be respected regardless of their place of employment.  It would
be ideal if hospitals were willing to have more than one level of LC skill on
staff.  Not every dyad needs the RN to help with a latch on, and the babies
in NICU may well need a higher level of skill than some LC's have acquired.

There are many examples of certification that still limits your field.  I
think of teachers.  You go to college, you get your degree, you intern, then
you are qualified to teach. BUT, if you trained to teach kindergarten, you
are not going to be qualified to teach calculus.  Oh, you may know calculus.
Maybe you could even make a great calculus teacher, but you would be working
out of your field, and the truth is, unless you return to school and add to
your credentials the calculus field (not to mention the extra to be a high
school teacher instead of kindergarten) a high school will not hire you.
What does that mean?  You are a teacher, you should be allowed to teach
wherever you want?  I would not want a teacher who studied kindergarten
education and early childhood development teaching my child's college prep
calculus when the alternative of a math major with certification for
highschool ed is available.  I know this is a very simplistic example.  If we
were talking licensed fields, I could just as easily use doctors. . .compare
a cardiac surgeon to a neurosurgeon. . .both are doctors, but who should be
operating on what?  They may both be excellent physicians, but  who is better
qualified for a double bypass? Or even RN's ... a nurse trained in geriatrics
and working geriatrics for 10 years.  Great geriatric nurse working with a
wonderful private doctor's practice . .but, decides she wants to be a
surgical nurse, but she has not been in an operating room in years....well,
doesn't she/he need a bit more training?  Is she insulted because she can't
get the position open at the hospital for surgical nurse?

LC's come from various backgrounds and offer various skills.  The IBCLC
credential shows only the skills we have in common, but does not and should
not be the only skills required to fill any particular position.  We should
respect that we are all qualified on one level, but many are qualified beyond
that.  This is a reality and not an insult to those who are not employed as
part of the medical establishment or a statement of superiority for those who
are.

Maybe if we start from the reality that we are all different and all know a
lot about breastfeeding, but some know much more about many things besides,
and others are just getting started and only know the basics, then we can
find a way to validate the value of each IBCLCs contribution to the health
care system and the well being of breastfeeding mothers and babies.  I think
we are more likely to be respected as professionals when we are honest with
ourselves about our capabilities and limitations.  Surely the skills and
abilities of a neonatal nurse practicioner IBCLC are far different from those
of an IBCLC with her education in a field unrelated to newborn medical care.
And, the skills of an IBCLC who has rarely sees a baby older than 3 days will
be different from the IBCLC working with babies who are weeks and months old.
 We all have valuable skills, but not all those skills translate into the
same job description.

Just my opinion, a NON RN IBCLC,
Pam MazzellaDiBosco, IBCLC  FL, USA

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