In a message dated 12/14/0 3:22:38 PM, [log in to unmask] writes:

<< I'm puzzled. Can somebody explain why these support groups and peer
counselors are necessary, when LLL is doing this? I am really concerned
about the possibilities of misinformation and lack of accountability
that could arise.>>

La Leche League is and always has been peer counseling. But when we ask
ourselves what *peer* counseling means, we have to ask ourselves how and why
it works. It is not only b/c women are able to find support and information
from their own peers, but b/c they can find it in a way that is accessable to
them. The format of La Leche League is a white, middle-class format. The
whole concept of support groups of this type are very accepted among white
middle-class women, but is not as accessable to everyone.
    I coordinated a bf peer counseling program for 4 years and learned what
worked and what didn't among a very diverse population. Teen mothers in our
community loved to get together w/ each other in a very informal setting
(like someone's home), always with food available(!) and they would learn
about bf almost as an aside to the rest of the conversation. They did not, as
we first thought would be true, want teen mothers as their peer counselors.
They were very open to learning from other teen moms, but really needed peer
counselors who provided more of a mothering role.
    The majority of our clients were single mothers, for whom the committment
of volunteer Leadership was too much to ask. Peer counseling, OTOH paid
poorly, but did pay something.
    We actually trained one of our counselors as a Leader and she ran a group
in the city for a couple of years, but very few of our clients came to the
meetings and in the end, she was serving a primarily suburban population. It
really was quite odd to have a single mother of two (who had been a teen
mother as well) doing all of the volunteer work (somehow none of those
suburban moms had time to help her) for a group that didn't even reach her
own community.
    Peer counselors worked much more one-on-one than Leaders do. They
initiated the contact with the mothers and followed up, not waiting for
mothers to call them. It often took a long time to establish the trust needed
to be effective in the relationship. Many of our clients moved repeatedly
during their pregnancies and while nursing. A peer counselor who lived in the
same neighborhood could more easily keep track of the mother than anyone else
could.
    Most of our clients were dependant on social services for health care
(remember health care is far from free in the US!), for financial assistance,
etc. Most service providers are professionals, but peer counselors are other
mothers from the same neighborhoods with the same life experiences.
    The AIM industry and the media have portrayed bf as relegated to the
white, wealthy and educated. We do nothing to change that perception when we
do not use peer support to promote bf.
    The only issue I have with peer counseling is that there is no standard
of education. LLL's training is excellent, depending on who teaches it and
what expectations the program has of both the counselors and the
coordinators. In my program, I trained about 40 counselors over 4 years. I
specifically sought African American, Latina, and bi-lingual counselors, as
well as those who had been teen mothers, as they reflected our population
base. I only trained women who had bf for one year or more or who were
currently bf, if less than one year. Our major focus was on increasing the
duration of bf. My staff were extremely well-trained and several of the
counselors who had worked for several years, IMO, could easily have passed
the IBLCE exam. Unfortunately, I have not observed this level of skill among
all other programs. Even so, LLL Leaders also have varying levels of skill
and the accountability factor is really rather limited, so I don't see this
as more than a wrinkle in the concept.
    Even LLL changes over time. When I stopped leading meetings, the majority
of our moms were working mothers, reflecting a changing population. IMO, the
reason they could feel supported was b/c there were so many other working
mothers at the meetings, too. It is easy to believe that the format of LLL
meetings should work in all situtations, but they do not.
Jennifer Tow, IBCLC, CT, USA

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html