As I wait on the exam results...this makes me very sad. I can't tell you how many women in the Nashville, Tennessee testing center were scared to death (literally white as a sheet and shaking like a leaf). I kept hearing (in different forms), "If I don't pass this year, I won't ever realize my dream of becoming an IBCLC!"  You could have cut the tension in the room with a knife. My heart was breaking for each of them. The enormous pressure these ladies were under couldn't have helped them score as well on the exam as they might have if they knew they could re-take the exam again next year.  As a nurse, the pressure was a little overwhelming, but I knew the opportunity would be there again for me.
  
I also kept hearing, "I can't believe how much money I have spent preparing!" I don't even want to add up what I personally spent (prep course out of town, text books, online exam practice courses, workbooks, etc.)  It seemed like many of these prep courses/books were preying on my insecurities about passing the exam. I didn’t want to miss one opportunity because “That might be the one which helps me pass!” Oh, not to mention the MANY incorrect practice questions and conflicting information (where is the accountability here?) given in each of the courses/exam prep books/text books...but that is another can of worms. I can't even imagine adding the cost of the new requirements on top of that, especially for women who live and practice in impoverished nations where they are so desperately needed. To me, this seems to be adding up to a very unhappy professional designation and one of exclusion. Obviously I hope and pray I passed the exam...but how can I feel good about excluding women (and a few men) because of funds, access to required courses, and other limitations which have been discussed previously?
 
As is true in other professions, this is usually where there is a split...a sort of spinning off from the original intent of a professional designation. I would really hate to see this happen in lactation. There are so many different designations NOW, most people are confused as to the difference between a CLC, CBE, IBCLC, ANLC, ALC, and who knows what else! If there is another "ultimate" designation in the future...it seems to me...it would undermine the perception of professionalism.

Warmly,
Marie Ivey, BSN, RN, LCCE, CLC
Chattanooga, Tennessee

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