My state WIC agency already allows the local agency to use a "trained" 
professional staff member (nutritionist or the breastfeeding promotion 
coordinator) to serve if an IBCLC is not available to the local agency. 
Many WIC agencies already "can't" find an IBCLC mostly because they 
don't want to pay enough, or guarantee hours, it is contract labor 
whenever they want the help or just for 8 hours of PC training once a 
year. This is what I call "the token IBCLC". Unless the person is an RD 
and IBCLC, she usually does not have a full time job or guaranteed 
hours.  The RD/IBCLC mostly does nutrition work. Trained means attending 
the first two state BF trainings (which are good courses).

I also do not think the local agencies would pay for the PCs to take 
this exam, nor pay to have an IBCLC work with the PC or RD for the 50 
hours or whatever it was. The PCs I work with are low income, mostly 
part time, and do not have $500 to take such an exam. The ones I work 
with can not afford to go to CE conferences. Many are low educational 
level and do not read or write well.

I do not believe that the second credential will funnel WIC employees 
into this approach. They will most likely go for the higher hours, with 
no supervision of an IBCLC because they can use the hours they counsel a 
nursing mother, not necessarily the time they are learning hands on 
skills. Especially if their agency is not willing to pay an IBCLC to 
train the staff member for the 50 hours.

If the local agency is not willing to have an IBCLC on staff with 
guaranteed hours right now, they are not going to pay an IBCLC to 
supervise the staff member who wants to take this second credential.

As it stands now, the work supervisor of a candidate to take the current 
exam does not have to be an IBCLC or anyone who knows anything about 
breastfeeding. This is easier and cheaper than having an IBCLC supervise 
and train someone for 50 hours.  Right now, you can take and pass the 
exam with book knowledge while the second credential will take more 
actual supervision by an IBCLC and hopefully more hands on training. I 
can't see this happening in the future as it isn't happening now.

Kathy Eng, BSW, IBCLC

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