Seems to me the major issue here is how to educate folks on what it means to be an IBCLC. This includes MDs, RNs, patients, grandmothers, and especially potential LCs. Obviously each of these groups and others may require a different approach, or even multiple approaches. One thing I do when introduction myself and my credentials to health care professionals is to give them a copy of the IBLCE brochure that explains very well WHY certification is important and what it takes to be eligible to certify. Back in 1989 when I decided this was a potentially "right" field for me, I was a Leader Applicant in LLL. I knew it would take me 2500 hours of practice consulting but figured there had to be some way of shortening that time. I wrote the IBLCE folks and explained that I had a Master's degree in Education and had taught 5 years worth of human anatomy and physiology and had nursed one child for 3+ years and was still nursing the second and that I had had personal experience with sore nipples, etc etc etc. I really thought at the time that was worth a significant chunk of those hours! I got a very nice reply from IBLCE saying that all that experience was wonderful, and now if I wanted to be eligible for the exam I needed 2500 hours of practice consulting.... I was not a happy camper! THEN I began realizing what is involved in this field--how many approaches there are to solve the same problem, and what works for one mom/baby may not have a chance for the next. And how much info there is out there on the science of lactation. What is the old saying? The more you know the more you realize you don't know? I was able to telescope the years from five into three by being in an area (Atlanta) that a lot was going on, and a lot of compulsion. When I actually took the test, it drove home the point that IBLCE is absolutely justified in requiring what it does to sit for that test. Mothers need to be educated that IBCLCs exist and have some kind of proof that certification is valuable. Prenatal classes, articles in popular magazines, etc. could help here. I don't know what the best way to convince the folks who call themselves LCs and don't have accurate info to back it up. Some of them could be taken on as "projects" by IBCLCs--personally inviting them to attend CERP sessions, sending them info on how to become certified, discussing case studies with them (as appropriate). And I suppose making sure the hospital administrators understand the meaning of certification. What else? Sorry for the long note. Melissa Vickers, IBCLC [log in to unmask]