If you wish to know what all the initials mean, one can always contact the  
course director and ask what the initials mean, what prerequisites exist for 
the  program, what public safeguards are in place, and why they insist on 
holding on  to these designations or in some cases creating competing credentials to 
the  IBCLC. These "certifications" are used as marketing tools to entice 
people to  take the course, so that potential students will feel that their time 
and money  is well spent by emerging with a set of letters after their name. In 
some cases,  it is much easier to sit for 3-5 days and take a little test 
than it is  to secure college level preparation and thousands of hours of 
clinical  experience. These letters serve to create an alphabet soup bowl of 
confusion for  the public, for the hospitals that employ lactation consultants, for 
insurers,  and for legislators and policy makers. 
 
Now the American Medical Association is targeting allied health  professions. 
They are going to examine the education and training of allied  health 
professionals and provide points of comparisons for legislatures. The AMA  is 
working hard to restrain how we are able to provide professional lactation  care and 
services. Because the LC community cannot agree on a standardized  
preparation path we have left ourselves open for another profession to do it for  us. 
How are we to be licensed if all these little courses insist that their way  is 
the only way and refuse to collaborate on standardizing pre-service education  
and supervised clinical experience? The nursing profession failed to do this 
and  is continuously paying the price. Most of these issues boil down to 
money. The  AMA does not want other professions to intrude on their ability to 
secure  payment for services. They wish to make sure that the bulk of limited  
health care dollars flow to physicians.That's why the AMA owns the CPT codes  
that are used to bill insurance companies. Lactation courses provide income for  
the directors of the programs. Placing lactation education into  colleges 
could disrupt the status quo. The addition of another credential  from IBLCE is a 
baffling approach to the above problems. 
 
Marsha Walker, RN, IBCLC
Weston, MA

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