Amy,
I can tell that you want to do everything you can to set up your program with ethical guidelines while still meeting your goal of being there to assist moms in need. I congratulate you for this.
I believe that mothers DO indeed fail to understand that there are a variety of levels of competence/qualifications for those in the lactation field. Since this is true, I strongly believe it is up to all of us, CLEs and IBCLCs, but especially CLEs to MAKE SURE EVERY mother understands the difference. I cannot count the times I have had a mother tell me the story of her breastfeeding failure, where she at some point states " and I even had a lactation consultant at the hospital help me!" The unspoken belief is clearly that this mother thinks she had professional help, and her problem was so bad even the expert could not fix it for her. I have verified this suspicion for myself many times by questioning mothers further, to find out that, in fact they had no idea that the person who she called a "lactation consultant" was actually a nurse with a UCLA Lactation Educator Certificate for a five-day training course under her belt, (plus whatever personal experiences she brought to the job, of course.) I don't mean to minimize the valuable contribution made by nurses and CLES- but I feel sad and angry for every mother who really did not know that there is additional, tested-and-found-competent IBCLC help out here.
In the case, for example, of mothers in the Bakersfield, California area where Amy's program operates, there may indeed be only 3 IBCLCs, but if I were a mom with a problem there, I would want to know that I could get highly skilled IBCLC help in Los Angeles- less than two hours away. I reside in Fresno, two hours away from Bakersfield, and I myself have referred a mother to Kitty Frantz in LA, and the mother was delighted to drive four hours each way to get the help.
So I sincerely believe that this is a situation that calls for a disclaimer. Something like: "Our lactation educators have passed a five day course in lactation assistance, and they are able to help with your non-complex lactation issues. Please also feel free to ask them for referrals to Board Certified Lactation Consultants in the local area if you wish." With this disclaimer, a mother can make an informed decision about what level of assistance she wished to utilize for herself.
Respectfully,
Sue Jacoby, IBCLC
Fresno, California
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