The issue which Kim Balzer raises about contact hours may seem like a double
bind, but it's hard for me to see another way for the IBLCE to begin to
describe some sort of common pathway towards LC competancy.  I agree with
those who posted who state that being an RN doesn't necessarily qualify one
for LC work, nor does being an RD or MD or whatever.  Lactation is a
sub-specialty with ties to other closely related fields, and all of us have
(hopefully) some insights from those professional or volunteer backgrounds.
 And hopefully we all take seriously the fact that we need to be reading
everything we can get our hands on about lactation --  not just in the books
moms read.  We need to look at the clinical data carefully and critically,
and go to conferences and always attend the sessions we know nothing about.
 Then we must go home and read as much of the stuff on the bibliography as we
can obtain.

That being said, there is still no substitute for seeing things first hand.
 I spent the first 5 years in private practice being terrified of how little
I knew, and this was after years and years of being a LLLL in the Prof.
Liaison Dept.  The mothers who see and need priv. pract. LCs are the worst of
the worst in terms of disasterous breastfeeding cases.  You do need
malpractice, and you do need to be very very humble about all the things you
don't know yet.

  I think the idea of apprenticing with a mentor LC is a very important
concept.  I've done this for several rookie LCs.  I'd like to see ILCA rough
out a protocol and cost analysis of how this could be done on a standardized
basis.  I know its rough for LCs with young kids to figure out a way to get
to where there is a mentor-LC located.  Perhaps there could be intensive 3-4
day deals worked out where several times a year people could get together and
really do the kind of hands-on needed.  Maybe there could even be deals where
senior LCs (with more flexibility vis a vis young kids) could travel to a
city and instead of doing a conf. do some consults which aspiring LCs could
line up.  That way the up and coming LCs could have the opportunity to
observe and practice techniques. Until there are more programs like the MS
program Chele started, I see the need for contact hours.  I'd also like to
urge more senior LCs to consider doing more  things for contact hours.  I'm
planning some.

I am still working on my conf. page.  I'm trying to figure out how to
organize all these categories I keep coming up with (like a place for you all
to sell your tapes and slides and books on-line).  Maybe I can have a space
to post people willing to do mentor-LC preceptorships.I need to get some
soft-ware which will compile posts so I don't have to do all this typing and
compiling daily.  I visualize it as a nightmareish work-load.  Any one
knowing of such soft-ware, please e-mail me privately.

Barbara Wilson-Clay, BSE, IBCLC
priv. pract. Austin