The debate about education and certification is not unique to our
profession.  There are millions of programs in the world offering
training in everything from natural medicine to car mechanics.  Today
you can get an MA from Harvard or from a number of questionable colleges
where the only requirement for admission is the ability to pay.  I have
a cousin who graduated a 4 year state university in the States who can't
point out a half dozen European countries on a map.  There are MDs and
RNs who are stuck in a time warp and don't know or care a fig about
breastfeeding and there are experienced LLLs working in the community
who are doing wonders with a shoestring budget.  I often question where
we should be heading - towards more and more education and
medicalization or back to our roots which puts the emphasis on support
and mothering.

Do I think our profession needs to set some guidelines to protect the
public?  Absolutely. I think it is a downright slap in the face to those
of us who have worked for years to become IBCLCs, that a hospital nurse
who has attended a weekend course tells patients she is a lactation
consultant.  4 and 5 day courses can be wonderful (they provide
information and get people started) and I have both taken and run them
myself - but the goal is to give health care workers and professionals
WORKING KNOWLEDGE, not to turn them into instant LCs.  I am all for
keeping the field of breastfeeding counseling open to community and lay
counselors as well as professionals as long as there are boundries...
just like doulas, midwives and OBs.  I use the services of a massage
therapist, chiropractor and orthopedic dr depending on the problem and
need.  As long as the massage therapist calls herself just that and
doesn't say she can treat broken bones, that's fine.

Perhaps representatives of ILCA, the IBLCE, LLL and the International
Childbirth organizations could get together to form some guidelines and
standards that would be accepted by all...

Some ideas off the top of my head:

1.  All courses that issue certification should apply to the above
umbrella organization to make sure it meets specific standards.
2.  Define the roles and obligations of each kind of counselor.  For
example,
a breastfeeding counselor must a minimum of one year or such and such
hours of approved education plus x hours of clinical hours.  She may
work in the following areas:  telephone hot lines, education... blah,
blah.
A lactation consultant or CLE or whatever must pass a minimum of 18
months approved education plus x hours of clinical hours.  She may do
such and such.
A LLL can do such and such...
An IBCLC due to her advanced training is permitted to work in hospitals
and clinics etc. etc.
Only IBCLCs that have gone on to do specialty work in suck training,
homeopathy or OC manipulation would be allowed to advertise and work in
that specialized field etc...

What do you all think?

Susan Nachman-Srebrnik, IBCLC (who has gone thru the whole route like
most of us.)

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