I have observed similar attitudes in Phoenix.  Recently, I called the County
Hospital about their provisions for an on-staff LC.  They have an RN doing BF
counseling.  I used to work there in the late '70s & early '80s as a BF
counselor, first as a volunteer, then on staff as a salaried Counselor I,
qualified by my 5 years'  experience as an LLL Leader, when one of their minimum
quals was a bachelor's, which I didn't have at the time. It was the first effort
by any hospital in the state to provide BF counseling to new moms.  Now, I do
have a BA, and IBCLC, but they are not interested.  They 'have the position
filled' by their RN who was sent out for a short course in BF.  Then I called
the WIC personnel dept.  They have RDs & nutritionists, also sent out for a
short course in BF, and their peer counselors.  (I know the lead RD at the Phx
WIC, and her info is very good.)  I asked if any were IBCLC and was told "we
can't quite do that."  I am under the distinct impression that the local medical
community puts more value on training courses (the shorter & cheaper, the
better) than on the exam and resulting Board Certification (and its cost to take
& maintain).  There is also instant shut-down when they learn I am self-trained
by experience, personal study & LLL.   They seem to believe that everything one
needs to know about BF can be put in one chapter of a medical text.  They have
no concept that BF info/research could fill a set of encyclopedias!

There are no IBCLCs on the staff of any private medical practice in Phx, &
perhaps in all of AZ.  A couple of hospitals are 'preparing' to apply for BFHI,
but that can take a long time.

We need (ILCA needs?) a good agent or PR firm to 'sell' the Board Certification
of IBCLC, as well as the other certifications like CLC, CLE,  what they mean,
and how a hospital or private practice can benefit from having one on staff.
Include in that reasons why the RN degree does not guarantee up to date BF
info/skills unless that RN has made a personal effort to update her skills &
training. (Sounds like personal study to me!)

Don't ever try to count on the news media.  Their entire focus is on conflict,
anything that differs from the norm (or what they perceive to be the norm) like
BFing an older baby who is walking & talking, using cabbage to resolve
engorgement, the BFing mom w/poor info whose baby gets in serious trouble, etc.
They print what I call the "Aint It Awful" story.  To them, discussing all the
fine points about BF is for advertising and PR 'hacks'.  Reporters are a much
higher life form--just ask them.

For those not in the US, WIC stands for Women, Infants & Children.  It's a
federal program that provides coupons for specific food products for low income
moms & kids.  It includes abm.  Mom's coupons end at 6 mos postpartum if she is
not BFing, but she can continue to receive them if she continues BFing, up to 1
year, I think.  My only complaint is I don't think they discourage abm enough
and I suspect many of the moms are only token BFing, just to get the coupons.
Didn't I read about certain elements in mom's urine that are present only if she
is BFing? How about a urine test to stay on the program?  After all, its in the
best interests of the govt (taxpayers) that these moms do the most possible to
assure the optimum health for their babies.

Phyllis Adamson, IBCLC
Phoenix, AZ
"Today's might oak is yesterday's little nut who held his ground!"    :-)