Dear all: The reason why I do not favor a "lesser credential" is that I feel we would be duplicating the efforts of many who have come before and have a far better infrastructure for providing this type of care than the more clinical IBCLC role. The "lesser credential" in reality is a "peer-counselor". There has been TONS of research on this in developing countries and in the United States. I have a huge document that I tried to share with Liz Lange's marketing director when she asked me to "prove that breastfeeding was best" called "Quantifying the Benefits of Breastfeeding: A Summary of the Evidence." that is about 150 pages of summaries of studies and conclusions about the overall results. We know peer-counseling works. We also know that there are plenty of organizations that do this well. Rather than reinventing the wheel for a "lesser credential" we should work with these organizations that have a much wider broad base of support than we have to "upgrade" their counselors. The reason why this makes sense is that they can provide all of the counseling skills that may be a little more foreign to some of us that come from a clinical background. A little fine tuning to develop a "peer counselor" program that works well with the sophisticated care with IBCLCs would be an excellent bridge. Furthermore, this would eliminate the confusion of many people who get confused about all the nonIBCLCs who have gone through short courses and present themselves as LCs. A good peer- counselor would be labeled as such. Secondly, I totally value the role of the front line RNs who work in the hospital. They deal with the initiation of breastfeeding under conditions that I would find intolerable. I don't have the patience to work through all the policies and would never have the ability to tear myself away from a client that needed me because I had to see 10 more that day. Nevertheless, this is where I have to point out that this is but one small window in a woman's breastfeeding relationship. I work on the problems that occur after the woman leaves the hospital all the way through weaning. While we certainly have an insufficient number of IBCLCs in the hospital we have an even bigger dearth of IBCLCs to help women once they get home. We have to stop thinking about breastfeeding as an event that happens in the hospital and more as a process that continues for a good time afterwards. There is no one else, not the pediatrician, not the nurse practitioner, not the obstetrician, who will have the time to sit through entire feedings from start to finish in today's medical climate. Can you imagine them spending an hour and a half watching the feeding, doing a pre and a post feeding weight check, in instances when mom is supplementing, watching the pump and whether her poor nipples and areolas turn into sausages because the pump companies have not fully grasped that women are not one size (or three size) fits all? There is a gap between these practitioners that needs to be filled. We not only need to recruit for the hospital environment, but also for the home environment. I mentioned before that in Manhattan we are now considered something akin to personal trainers. And maybe that is not such a bad thing. This is why I think it is a travesty to consider the IBCLC an "Add-on" You would not think of an RD as an "Add-on". You would not think of a psychologist as an "Add-on" profession. You would not consider an occupational therapist as an "Add-on" profession. By considering our profession an "Add-on" it trivializes the importance of women being able to get solid clinical help while breastfeeding. This is what I consider to be one of the main problems for women trying to breastfeed in our modern society. They are told be pediatricians that nipple pain is in their heads, they are told by the breastfeeding books that it should just happen "naturally", they are told that they should get advice from mothers, sisters, friends who have all grown up in a culture that has only recently regained its sense of value in breastfeeding. Many of those mothers, sisters, friends may have been luck and have no idea how to help or the "do or die" type that may not empathize with the mother that has more difficulty handling the problems. Far from considering the IBCLC as an add on, I think we should work hard to have it been seen as a full profession in its own right. Not just for our own sake, but for the mothers we are helping. Best regards, Susan Burger *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html