Dear all:
There are many IBCLCs who have professions that make for an excellent background in supporting
breastfeeding. None of these backgrounds should be considered any less valuable for
communicating to other health care practitioners.
Some of us are clinical psychologists, nutritionists, registered dieticians, herbalists,
accupuncturists, MDs and many other professions. At this point in time the profession of IBCLCs
is dominated by RNs who also add their valuable perspective. This perspective, however, is not
the only perspective and does not mean that the rest of us who are not RNs have any inherent
lack of capacity in communicating with other health care professionals.
Moreover, I do not feel that a United States hospital-based system should be the standard for all
IBCLC practice. At present, the managed health care systems in the United States are severely
limiting the scope of nursing care. California is in a severe crisis because of lack of nurses and I'm
sure that is the case in other states as well. The ability to help with breastfeeding within the first
2-5 days is important, but not sufficient and severely constrained by staffing cutbacks in many
hositals in the United States. Most of the breastfeeding relationship occurs outside of the
hospital and deserves support.
Outside of the hospital setting is no other profession where free-standing health care
practitioners such as clinical psychologists, nutritionists, dietitions, speech therapists, etc are
effectively "gagged" if they have a disagreement with another health care practitioner. Yes, they
should retain professional standards and explain why, on an evidence basis, they disagree with
the other practitioner. But they are not "gagged" from saying they disagree.
Best regards, Susan Burger
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