For someone who re-certified by exam in 2010 this discussion has been easy
to avoid with the thought that it's four years until my next
re-certification, which I hope won't be by exam.  I will openly admit to
complete ignorance of all the changes in the requirements for certification,
and until this discussion I really hadn't noticed any of the issues raised.
But when I read Liz Brooks' post with this quote from the IBLCE website, I
*almost* got curious enough to go there myself and read up on it.  I say
almost because I find the IBLCE website frustrating to use so I visit it
about every five years if I absolutely have to in connection with
recertifying.
Here's the quote: ""When applying for the IBLCE exam, candidates must
demonstrate completion of continuing education in the following 6 topics.
These continuing education courses may be provided by independent education
providers or academic institutions.  (Basic life support (for example, CPR);
Medical documentation; Medical terminology; Occupational safety and security
for health professionals; Professional ethics for health professionals (for
example, the IBLCE Code of Ethics); Universal safety precautions and
infection control."

Except for my participation on Lactnet, all my work with breastfeeding is
done in Norwegian.  We have so few candidates for the exam, and very
little relevant Norwegian literature to prepare anyone to take it, so we all
sit it in English, but I am pretty slack on other medical terminology
because I don't often use it anymore.  Could one risk being asked about
English medical terminology on the exam?  Or occupational safety?  Or must
candidates simply document that they have taken CEUs in these areas, while
the content of the exam will remain more directly breastfeeding-related?
And do we have to show that our CPR training is up to date every time we
re-certify?  Forgive me for asking here - I am just not up to facing the
IBLCE website tonight.

I agree with Heather's comments on what seems to be IBLCE's lack of
awareness and/or interest in systems of care in other countries than the US
- and that is nothing new.  Here in Norway there is no one who is employed
in the health services on the strength of being an IBCLC.  All of us have
our jobs because of another credential, nursing or midwifery, and the IBCLC
is on top of that.  The addition of the requirements outlined from 2012 will
not change that, because IBCLCs do not figure in the legislation regulating
health professionals in this country.  How could we, when there are only
about a dozen of us in all of Norway?   I also agree with Teresa, that we
should be concerned about whether the new requirements will improve IBCLCs'
capacity to help mothers breastfeed, or raise the proportion of babies being
exclusively breastfed.  Where is the evidence to support the changes?  And
Teresa, I have also heard that exam candidates with backgrounds from
mother-to-mother organizations do tend to get higher scores on the IBLCE
exam than candidates without such backgrounds.  This doesn't mean they do a
better job as IBCLCs, it just says that the exam seems to reward that kind
of knowledge, which I believe was part of the intention from the beginning.
And before the flames start, let me say that I was an RN before I was a
mother-to-mother counselor, and my day job has been as a staff midwife on
postpartum in a mainstream Norwegian hospital for most of the last 23
years.  (23 years? yikes - yes).  So my own criticism of all the damage done
by hospitals is as much a self-indictment as an accusation.

And more than one person has pointed out that EVERYONE should know how to do
CPR.  Could this not be an argument for IBLCE not to bother mentioning it?

Someone mentioned that IBCLCs should be contacting IBLCE, so they hear from
'members'.  IBLCE is the board of examiners, NOT a professional association
for LCs, and no LC is a 'member' of IBLCE.  IBLCE is a board consisting of
people chosen according to the by-laws of IBLCE to meet criteria intended to
make the board representative and accountable not just to LCs but also to
the public.  But IBLCE has been swayed by organizatons of LCs before, as
when IBLCE presented a scope of practice that aroused a similarly excited
discussion on this list and withn ILCA.  ILCA appointed a committee to write
a scope of practice and my hunch is that IBLCE were pretty embarrassed when
they realized what a fiasco their own attempt was. If they weren't, more's
the pity, because they certainly ought to have been.

While I'm at it I want to say something about the ABM galactogogue piece and
hammers (and other tools).  Thanks, Wendy, for your comments on
galactogogues - my sentiments exactly.  For me it's a relief to know that
women are not missing out on the most effective help if I can't throw
pharmaceuticals at them every time they seem to have a dip in supply.  I can
not *recommend* domperidone to a mother without breaking at least one law
where I live - and where Wendy lives, mothers can buy it without a
prescription at any pharmacy.  We are able to obtain it legally by
collaborating with savvy and sympathetic doctors, but frankly I rarely miss
it, and I don't think our outcomes are a whole lot worse than they are in
places where domperidone is more readily available.  So, about the hammer:
in a talk about maternity care a speaker said 'to the man with a hammer,
everything looks like a nail'.  Apropos galactogogues, or pumps, or
acupuncture, or counseling skills, or just our professional identity -
whatever it is we are most familiar with as a tool will color our view of
the problem confronting us.  The art of good practice consists of
recognizing that bias in ourselves and consciously keeping an open mind so
we remember the other tools we keep in the lower trays of the box, like the
chisels, pliers, wrenches, and of course that little hexagonal thingie you
use to assemble IKEA furniture.  You learn more AND have a lot more fun
besides, all while getting to hang around with breastfeeding mothers and
their children :-)

Rachel Myr, IBCLC, midwife
caught up on this week's posts at last, after self-imposed internet
moratorium
just passed the six-month milestone of grandmotherhood :-)

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome