Well, it seems some found the tone of my response to Jan's comments
inappropriate.  I apologize if I offended anyone.  I understand that some may
take offense easily over these issues, though I did not think I took offense
too easily.  I felt my feelings were justified and were expressed calmly and
rationally without meaning to reciprocate any offense.  Again, I apologize
and take full personal responsibility if I did that.  Some of the comments I
felt were hurtful and inappropriate for our discussion here, and I guess I
was trying to express that.  Perhaps I did it inappropriately.  I WANT so
much to discuss this issue, and I am energized at the prospect of talking
about breastfeeding issues, especially the tough ones.  Perhaps those are the
most worthy of discussion.  I just hope that we can use language that builds
and edifies.  I am speaking to myself before anyone else here.

Jan, you stated that I took your comments out of context.  You said that your
comments were "NOT directed at individuals, but at the use of the term
'certified'..."  To quote in entirety, you said, "All of these various
intials which imply certification are 'end of course' certifications--and as
you can see, if they are confusing to US, imagine what it does to the public!
 The mother thinks that she has a lactation consultant, and actually it's
someone who has gone through a 'one-day-wonder-course' and has been deemed
'certified' by the instructor.  Great marketing ploy on the instructor's
part, very confusing to the public, and does not indicate any level of
competency on the part of the certificant."  I absolutely apologize if I
misunderstood you, Jan.  It still seems to me, though, that you are talking
about individuals when you use phrases such as "a lactation consultant,"
"someone who," and "the certificant."

I share your concern, actually, that there are those out there who tote
initials and give advice without truly being competent.  I will post again
what I posted in my original description of my CLE title.  It was made very
clear to me by CAPPA (and rightfully so) that this certification DOES NOT IN
ANY WAY enable me to "counsel" or "consult with" mom/baby pairs who are
experiencing breastfeeding difficulties.  It was furthermore made clear to me
by CAPPA that this role is for those who have earned it (MDs, RNs, IBCLCs,
etc.)  My role is strictly as educator.  In that role, I educate the
community on breastfeeding issues.  I can teach breastfeeding classes to
expectant moms and write freelance articles about breastfeeding issues (among
other things).  In fact, I will quote their policy, "The purpose of the CAPPA
lactation educator certification program is to provide childbirth
professionals with comprehensive training in breastfeeding education.  When a
candidate completes the certification process they will be qualified to teach
and educate the public on breastfeeding and related issues.  When all the
requirements have been satisfactorily completed candidates will be issued the
CAPPA credentials "CLE", certified lactation educator.  This program does not
issue lactation consultant status, and does not qualify one to issue medical
advice, diagnose medical conditions for mother or baby or to prescribe
treatment or medication."  CAPPA is a highly professional organization (not a
fly-by-night, take-your money-and-run kind of organization, though I
acknowledge there are some out there) that has had such notable people
associated with it as Polly Perez, Dr. Walter Larimore, Connie Livingston,
Dr. Marsden Wagner, Henci Goer, and LACNET's own very distinguished and
competent Dr. Kathy Dettwyler.  Perhaps we should all take a breath, ask some
questions, and do some investigation before we blanketly condemn all
certifying entities.  Again, I say that while at the same time echoing the
concerns you have, Jan, about "empty certifications."

I would like to add here too that just because the requirements for
certification are not the same for every certifying agency but do confer the
same initials does not mean that they are not valid requirements or initials.
 It is like getting a CCE (certified childbirth educator) certification.
There are dozens of organizations who offer the certification, each with its
own unique list of requirements.  That does not mean, however, that the
person with a CCE is incompetent because their requirements were not
nationally mandated.  I think we all have admitted here on this list a number
of times that just because IBLCE has an internationally mandated program,
this international regulation has not stopped many IBCLCs from giving
inaccurate and unhelpful advice when they choose to.  I think the issue is
more about the misuse and unprofessionalism of a few individuals rather than
the incompetence or fraudulism of the certifying agencies as a whole.

Someone also mentioned that there was some question as to who would address
any grievances that a mother might have against one of these certified
people.  I can't speak for other certifying agencies, but CAPPA has a very
firm code of ethics and a formal grievance policy/procedure for when a mother
has a complaint against one of their members.

There surely must be something said about trust of others.  There should be a
level of trust, perhaps, for those of differing certifications.  Perhaps we
should trust that those people know and observe the perameters of their
particular certifications.  Again, perhaps, there should be a time for
questions and responses--a free and professional exchange of
information--rather than a pre-judgment.  I REALLY appreciated Mary Alice's
comments and questions.  They were highly professional and terribly relevant
to the discussion of concerns over certification initials.

On the subject of Mary Alice's questions, I hope I have answered them with my
above information.  I also hope I am not the only person without an IBCLC to
respond to her questions.  To recap for Mary Alice, I educate my community on
breastfeeding issues by teaching classes and doing freelance writing.  I do
not see mother/baby pairs.  I refer ALL breastfeeding problem calls to an
IBCLC or a local LLLL (unless it is a friend).  (I am a retired LLLL and not
able to take calls for them anymore either.)  I do not have a practice--I
consider it more an educational sole proprietorship.  (I am at my best when
addressing groups.)  I also think I answered Mary Alice's question about what
I was told by CAPPA regarding the perameters of my certification by posting
their official policy above.

By the way, I hope it is appropriate to post their website for those of you
who want to investigate them further.  I don't think this would be considered
an advertisement for them given the discussion vein thus
far--www.childbirthprofessional.com.

I hope my post helps in some part to clear up this matter and further this
discussion professionally.

Jessica Harrison Carlyon, MBA, CD, CLE

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