I see the major problem of "getting counseling hours" to be who is the
"mentor"?  In every area many can probably say, "Jane So&So" is an IBCLC and
you won't believe what she tells moms!!!!"  I often cringe when I hear some
of the information or should I say misinformation being dispensed by
certified IBCLCs. Just because you can pass the test, just because you have
helped moms breastfeed for the required hours, does not mean you give out the
information you learned....even doctors give out information that makes us
cringe, why would IBCLC's be any different?  What if this IBCLC giving out
incorrect info is now responsible for the hours of 'hands on" of more IBCLC
candidates now perpetuating her misinformation for the newcomers to dispense.
 After all, they learned from Jane So&So and she is IBCLC after all.  How
will IBLCE monitor those responsible for "teaching hands on" and will there
be enough people around the world to fill those positions?  What special
training will be required of them to become facilitators of "hands on"
lactation education?

Also the comparison of IBCLC to specialists in the health care field is an
accurate comparison, but as I see it, in a different way.  Where becoming a
general physician is a field of medicine in and of itself, becoming a
specialist requires more specialized training and education in the specific
field.  For instance, neuro-surgery would require a different education than
oh....obstetrics.  I wish IBCLC had the same classifications of specialties.
I like the idea of General IBCLC and perhaps adding to that in terms of
specialties.  There are some out there who are miracle workers with cleft
palate, down's syndrome, or severely premature babies.  Why not find a way to
separate the "specialists" from the "regular" without one being necessarily
better than, just more experienced in particular fields.  I think my family
doctor is wonderful, he can help with most issues, but if I ever need open
heart surgery, I am not letting him do it. I see these sub specialties in
many areas of health care...RN's who have specialized training in cardiac
surgery or geriatrics probably do better in those areas than they would do in
labor and delivery or NICU.  In my area there are even two or more ways to
enter the world of RN...tech school and college...18 months, 2 years, and a 4
year bachelor of science in nursing will all end up with the RN after their
name.   I don't think IBCLCs need to be able to do it "all" in terms of every
lactation issue anymore than I think any health care professional needs to.
But, I do think IBCLCs should know when the level of expertise they have does
not meet the mom and baby's needs and refer her to someone more qualified.  I
would really like it if there were some method of identifying those more
qualified in a particular aspect of lactation difficulties.

Only an opinion.
Pam MazzellaDiBosco,  IBCLC

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