For someone who re-certified by exam in 2010 this discussion has been easy to avoid with the thought that it's four years until my next re-certification, which I hope won't be by exam. I will openly admit to complete ignorance of all the changes in the requirements for certification, and until this discussion I really hadn't noticed any of the issues raised. But when I read Liz Brooks' post with this quote from the IBLCE website, I *almost* got curious enough to go there myself and read up on it. I say almost because I find the IBLCE website frustrating to use so I visit it about every five years if I absolutely have to in connection with recertifying. Here's the quote: ""When applying for the IBLCE exam, candidates must demonstrate completion of continuing education in the following 6 topics. These continuing education courses may be provided by independent education providers or academic institutions. (Basic life support (for example, CPR); Medical documentation; Medical terminology; Occupational safety and security for health professionals; Professional ethics for health professionals (for example, the IBLCE Code of Ethics); Universal safety precautions and infection control." Except for my participation on Lactnet, all my work with breastfeeding is done in Norwegian. We have so few candidates for the exam, and very little relevant Norwegian literature to prepare anyone to take it, so we all sit it in English, but I am pretty slack on other medical terminology because I don't often use it anymore. Could one risk being asked about English medical terminology on the exam? Or occupational safety? Or must candidates simply document that they have taken CEUs in these areas, while the content of the exam will remain more directly breastfeeding-related? And do we have to show that our CPR training is up to date every time we re-certify? Forgive me for asking here - I am just not up to facing the IBLCE website tonight. I agree with Heather's comments on what seems to be IBLCE's lack of awareness and/or interest in systems of care in other countries than the US - and that is nothing new. Here in Norway there is no one who is employed in the health services on the strength of being an IBCLC. All of us have our jobs because of another credential, nursing or midwifery, and the IBCLC is on top of that. The addition of the requirements outlined from 2012 will not change that, because IBCLCs do not figure in the legislation regulating health professionals in this country. How could we, when there are only about a dozen of us in all of Norway? I also agree with Teresa, that we should be concerned about whether the new requirements will improve IBCLCs' capacity to help mothers breastfeed, or raise the proportion of babies being exclusively breastfed. Where is the evidence to support the changes? And Teresa, I have also heard that exam candidates with backgrounds from mother-to-mother organizations do tend to get higher scores on the IBLCE exam than candidates without such backgrounds. This doesn't mean they do a better job as IBCLCs, it just says that the exam seems to reward that kind of knowledge, which I believe was part of the intention from the beginning. And before the flames start, let me say that I was an RN before I was a mother-to-mother counselor, and my day job has been as a staff midwife on postpartum in a mainstream Norwegian hospital for most of the last 23 years. (23 years? yikes - yes). So my own criticism of all the damage done by hospitals is as much a self-indictment as an accusation. And more than one person has pointed out that EVERYONE should know how to do CPR. Could this not be an argument for IBLCE not to bother mentioning it? Someone mentioned that IBCLCs should be contacting IBLCE, so they hear from 'members'. IBLCE is the board of examiners, NOT a professional association for LCs, and no LC is a 'member' of IBLCE. IBLCE is a board consisting of people chosen according to the by-laws of IBLCE to meet criteria intended to make the board representative and accountable not just to LCs but also to the public. But IBLCE has been swayed by organizatons of LCs before, as when IBLCE presented a scope of practice that aroused a similarly excited discussion on this list and withn ILCA. ILCA appointed a committee to write a scope of practice and my hunch is that IBLCE were pretty embarrassed when they realized what a fiasco their own attempt was. If they weren't, more's the pity, because they certainly ought to have been. While I'm at it I want to say something about the ABM galactogogue piece and hammers (and other tools). Thanks, Wendy, for your comments on galactogogues - my sentiments exactly. For me it's a relief to know that women are not missing out on the most effective help if I can't throw pharmaceuticals at them every time they seem to have a dip in supply. I can not *recommend* domperidone to a mother without breaking at least one law where I live - and where Wendy lives, mothers can buy it without a prescription at any pharmacy. We are able to obtain it legally by collaborating with savvy and sympathetic doctors, but frankly I rarely miss it, and I don't think our outcomes are a whole lot worse than they are in places where domperidone is more readily available. So, about the hammer: in a talk about maternity care a speaker said 'to the man with a hammer, everything looks like a nail'. Apropos galactogogues, or pumps, or acupuncture, or counseling skills, or just our professional identity - whatever it is we are most familiar with as a tool will color our view of the problem confronting us. The art of good practice consists of recognizing that bias in ourselves and consciously keeping an open mind so we remember the other tools we keep in the lower trays of the box, like the chisels, pliers, wrenches, and of course that little hexagonal thingie you use to assemble IKEA furniture. You learn more AND have a lot more fun besides, all while getting to hang around with breastfeeding mothers and their children :-) Rachel Myr, IBCLC, midwife caught up on this week's posts at last, after self-imposed internet moratorium just passed the six-month milestone of grandmotherhood :-) *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. 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