Dear Pat,

Well, maybe I just need more practice than other people to stay sharp.  However, when you are only seeing one mom a month, or sometimes even less - have had the occasional reallly slow time - one does begin to feel just a bit out of the swing of things.  Yes, the stuff I see in private practice is different than in the hospital - in fact now I get mostly train wrecks after the mom has given up on the ped, the hospital LC, maybe LLL.  But it does also help to see moms not in so much trouble, run of the mill stuff.  The reason I have become a fan of using the asymetrical latch is from helping moms use it so much in the hospital and seeing how well it works.  I have learned a lot about frenulums from looking at so many of them and seeing the range of difference there can be in a tongue tie.   I have learned that you can have a very alert baby after a medicated birth and a  very sleepy baby after an unmedicated one - I don't jump to conclusions so quickly anymore after seeing reality vs. theory on a much larger scale.

LC education reminds me once again of my training as a medical technologist.  For three years it is all theory and books - biology, chemistry, biochemistry, physiology, etc.  But in the fourth year you intern in a real lab, or in several labs.  If you get a good internship, you end up able to work as a tech.  In a poor internship, you mostly watch or do scut work.  After that year, you can take a registry exam, if you want to, or you can get work without taking an exam - most hospitals prefer registered techs and they generally make more money, but in a tight labor market, we take just about anybody with some kind of science degree and train them on the job.

When I became an LC, I came up through LLL.  I had very good counseling skills and knew what a healthy breastfeeding baby looked like.  But I didn't know much about abnormal physiology or even what the inside of a baby's mouth felt like.  I went to a Chele Marmet conference and felt like I had landed on a different planet.  My first ILCA conference was a revelation.  My relationship with LLL became strained - I was learning so much, but wasn't really allowed to pass it on (that whole situation has change now, thank goodness).  But getting the kind of experience that I really needed at that point was very difficult.  Nowdays I think that it is getting better.  But still, if you are in an isolated area and not getting a lot of work, how do you stay on top of things?  You can read, go to conferences, do Lactnet (where I have learned almost everything new in the last few years, or at least been pointed in the right direction to get the knowledge), but there is no substitute for hands-on work.  Now, if you have been doing this long enough it's like anything else, you don't need a lot of work to maintain your skills - I could go for many months or even years and still be able to draw blood well or do a diff (med tech stuff).  But for someone starting out, I think that the hands-on with a lot of babies is very important.  Also, it is important to see breastfeeding babies at all stages - newborn on up - and this is where many LCs who only have worked in the hospital setting get shortchanged - they never see what happens next.

So, this is getting very long, but I think that it is an important issue which ties into the whole thing of what the lactation consultant profession is or will be.  I enjoy the continuing dialogue on this issue.


Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[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(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html