I just wanted to add another voice to this discussion.  I became an RN first, then a LLLL, and then an IBCLC.  I've been working at the same hospital for nearly 10 years, the last 2.5 years as an inpatient LC.  There are currently 8 RN/IBCLCs working as LCs at our hospital.  None of us are ever asked or expected to work as bedside RNs.  

I work mainly in the NICU and the NICU step-down unit, and most of the babies I work with are preterm or have various illnesses or congenital anomalies.  Many of the moms I work with have serious health challenges of their own.  I find my training and experience as a pediatric RN very valuable in my work as an LC---specifically, in helping me to recognize and understand the physical challenges that the babies face, and in engendering the trust of the doctors, nurses, and other staff members I work with.  Like private-practice LCs whose counseling on nutrition draws largely from their own study and experience in that field, rather than from their lactation-specific training, I find that much of what I see and do at work was not covered at all in my lactation-specific classes, or in the lactation conferences that I have attended so far.  I think that a non-RN LC could perform my job functions, but I'm not sure where else but a NICU-like environment she would be able to gain experience working with many medically fragile newborns.  

The field of lactation consulting is greatly enriched by the varied backgrounds and life experiences that LCs bring to their work.  I think it's important for us to celebrate the skills and experiences of non-RN IBCLCs, and to promote the hiring of non-RN IBCLCs in hospitals, without discounting the valuable skills that RN/IBCLCs can and do bring to their work.

With respect,
Lisa Lostetter, RN, IBCLC, LLLL
New Mexico, U.S.A.

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