On another note, I have been reading Cathy Watson Genna's new book, Supporting Sucking Skills in the Breastfeeding Infant.  I feel like I have just stumbled across the Rosetta stone,the key to helping the mothers and babies I couldn't reach before.  Cathy has taken an interdisciplinary approach, drawing from medicine, child development, speech language pathology, neurology, and more, and laid it all out and organized it, in a way that perfectly articulates what we are seeing out there in our consult rooms, both the normal and the "other" presentations.  It's dense.  I have to really sit with it for a bit before the info penetrates, that's my brain ossifying.  Too bad I didn't have this book ten years ago....
I am going to make a public confession: I have often felt like an imposter in my work.  In addition to my IBCLC credential I have an MS in human development, (I studied mothers and babies in the childbearing year) along the way I was LLL accredited and also a certified childbirth instructor.  Don't get me wrong, I'm legit.  But there is something missing in my education, and this book is the proof of that. That it exists, that Cathy and her co-authors could put this together is inspiring and thrilling, but it is also an indictment of the way IBCLC's are educated.  What they have written is a college textbook, which could be (easily) a semester's worth of challenging, engaging material. But in the absence of a degree program (I am aware that one or two exist) some of us will read it and some won't. 
 
I'm not saying that we need to be cookie cutter, stepford LC's, in our education, but I am saying I earned my IBCLC fair and square, I strive for excellence in my practice, and I don't know nearly enough to do my job well when I get other than normal presentations at breast, at least I know that.  And I'm the expert!
 
What I don't have is a degree in human lactation, I'm quite sure few of us do.  Why not? Why do we each one of us have to piece it together and carve out some kind of habitable, workable niche in our communities, why the struggle? IBCLC's should be licensed members of the health-care team who come out of an accredited degree program, separate from nursing, with supervised clinicals in a variety of settings, demonstrable skills, ready to step into jobs that pay an appropriate wage. 
Best
Kristen Panzer, MS IBCLlC
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