Nicole,

This is a new profession, so we are not yet as organized as we someday 
will be, but we are far more organized than when I started 15 years ago.

The reason there is no "one" educational pathway is that there are many 
disciplines that have practices and information that are helpful for 
IBCLCs to know, so the field was originally envisioned as one that 
people with many kinds of preparation could come together in and cross 
pollinate each other. I've learned tremendous amounts about sucking 
issues from speech, occupational and physical therapists and their 
literature and conferences. Many of our tools are engineered, and a 
knowledge of engineering issues can help us use them more effectively 
(thanks, Linda Pohl for providing this). I use my own background in 
human biology, physiology and genetics constantly in this job. Over the 
past few years, there has been a delineation of core knowledge that is 
important, in the form of prerequisite courses and the exam blueprint. 
This can (and has been) used as a guideline for course selection. I know 
at least one IBCLC who designed her own degree program in human 
lactation using that.

I'm sure as the profession matures we will come up with a body of 
knowledge and impart it to college students who will be our future 
colleagues. I'm glad you found a program that meets your needs for 
structure and guidance. The designers and faculty of that program have 
done a lot to codify some of the knowledge base we will need in the 
future. That said, I think we are too young a profession to close off 
inside ourselves yet. So welcome to the great melting pot that is lactation.

As for making a reputation, you'll do that slowly. When I started, many 
moms were shocked that there was a fee for my services. Lately, in the 
past 2 or 3 years, one of the first questions they ask is what my fee 
is. If you are the first IBCLC in your community, you will educate moms 
slowly, and they will start educating each other, and then seeing a 
lactation consultant for bf problems will become part of your local 
culture. I love private practice, it gives me the flexibility to have a 
family life, and to do my research, write and travel to teach without 
having to negotiate with a boss. All I need to do is find colleagues 
willing to take over my practice for the duration of a conference. On 
the other hand, it's long hours, and I feel responsible to help moms as 
quickly as I can, which causes a certain amount of constant stress. It's 
emotionally exhausting too, even when you are careful to set appropriate 
boundaries. There's no truly "getting away" unless I can turn my 
practice over to someone else. Even if I don't answer the phone at 
night, I do check the message and then it's on my mind until morning! It 
helps to state business hours on the phone, then at least mothers don't 
expect immediate response on weekends or evenings.

Good luck as you find your path.
Catherine Watson Genna, IBCLC  NYC

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