LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
"Linda J. Smith" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 28 Dec 1996 13:49:32 -0500
Content-Type:
text/plain
Parts/Attachments:
text/plain (16 lines)
Lisa, this debate has been going on for years and can be summed up thus: "is IBCLC an entry-level certification or an advanced certificate?" If it's advanced, then that begs the question:  What could be safely be left out of a "lower" certification or credential? 

I was part of the group that did the original research to develop the exam in 1982-85. It has always been designed to test minimum competency in lactation, not advanced skills. The 2500 hours was carefully chosen as the time it would take the average individual to see enough mothers and babies to really KNOW normal breastfeeding in all its combinations and permutations. In an informal study done in 1992, the single most important discriminator between "competent" and not-so-competent breastfeeding care providers was clinical experience (direct contact) with many breastfeeding dyads. 

A credentialing exam is very expensive to develop and run. The going rate for most certifying exams is $100,000 to begin, plus more to administer on an ongoing basis. There are rules that govern certifying agencies, just to make things more interesting. Definitely a non-trivial undertaking.

Many of the lactation management courses (including mine) have a "mock exam" as part of the course. This helps students make the decision whether they are ready to take the IBLCE exam that year, or should they wait. Some of our students already know they don't have enough hours with moms, but take the course anyway so they can provide better quality help while they accumulate the necessary number of hours to sit the exam. This is far better than gaining experience by blundering around, possibly doing inappropriate stuff, IMHO!

ILCA is working on an accreditation program for lactation courses. It's possible that once this piece is in place, IBLCE will require completion of an accredited course in order to sit for the exam. And the issue of supervised clinical hours as part of an accredited course has come up repeatedly in the Course Directors meetings for the past 4 years. We all know it's needed, but the sticky part is how to make it happen fairly with sufficient protection to the mothers and babies. 

IMHO, most people have gaps in their knowledge base, and many of the courses help fill in the holes. (I wrote a piece on this for ILCA in 1992.) In the early years, many of the people taking the exam were volunteer mother-to-mother counselors like LLL Leaders. They know the breastfeeding relationship and counseling issues very well.  More recently, many nurses take the exam with only early-postpartum experience in breastfeeding. They know the hospital piece and sick-baby stuff very well. And dietitians (often from WIC) know how great the milk is. Each needs to find ways to gain experience in the OTHER areas pertinent to breastfeeding. 

The long-term solution is formal education in lactation, just like there is formal education for nursing, accounting, etc.  Students don't get paid to be students in other fields - in fact they have to PAY for their education to enter the profession. Apprentices aren't paid, either - they usually pay a fee to be an apprentice in the profession. My son can't work as a lifeguard without current Lifeguard certification, and must pay to take the course every 3 years. Of course he can rescue someone even if his certification lapses - so can I. But that's not the same as paid employment in the field without appropriate credentials. Just because I have a degree in Phys Ed doesn't mean I can get work as a swimming instructor - I need to have current WSI certification because it's the credential specific to the activity.

Linda Smith, Dayton OH

ATOM RSS1 RSS2