If then, it is decided that an IBCLC cannot operate within the SoP that
eventually does emerge, is it possible to no longer be one?  Call yourself
whatever makes you happy and practice accordingly. Realistically, IBCLC means
nothing to most consumers.  They don't know an IBCLC from a CBE from a CLC  from a
Breastfeeding Specialist of any name.  Wouldn't it be possible then  to just
not bother with the credential if it limits the ability to provide care,  and
just obey the laws in your given country or state about practicing medicine
without a license?  I am fairly adept at providing information and letting  moms
come to their own conclusions, but I always feel like an idiot for acting
like I am as dumb as dirt about their condition.  It feels foolish to be
getting paid for discussing thrush without discussing that they have it or that
tongue ties are real and their baby has one and it matters while at the same
time trying to make it seem so irrelevant that if their doctor sees a concern,
great and if not, no problem if they suffer and their baby suffers.  Who
decides when breastfeeding is a medical concern, and when it is feeding a  baby?
That may be another issue that needs to be considered.  Is the  understanding
that breastfeeding is indeed a medical event to be managed by  health care
providers?  Do the health care providers themselves see it as  such?  When does a
hcp view breastfeeding as medical and when is it feeding  the baby?

Maybe if nothing else this discussion will provide some impetus to giving
the credential some meaning with the goal towards a meaningful profession that
is indeed a team member, not just an interloper walking on eggs trying to not
offend anyone with their different opinion.  In a team, everyone's view is
heard and the object is to win...not lose breastfeeding so a health care
provider can be saved from contradiction.  I am very lucky I admit because  most of
the hcp's in my area are indeed breastfeeding supportive and the  struggle is
not so great.  There are the few who do not value  breastfeeding, but they
are a small  minority..  I have doctors who  work as hard as the mommas to find
a solution for breastfeeding problems, so I  don't have to worry so much about
contradicting anyone.

I do however prefer that we are not prevented from sharing information that
is easily found on any website or in any book that supports what we are
saying.  It seems foolish to me to be so worried about conflicting views  that we
watch a mom end breastfeeding just so she won't be confused.  This  is such a
patronizing attitude.  Information is power and women have the  right to
information.  How they use it belongs to them! Not to the IBCLC,  not to the nurse,
not even to the doctor.  They are the ones in  charge.  Perhaps if we remember
that the leader of the team is not the  doctor or us, it is the mother we can
find a SoP that represents what we  do.  In my opinion, we serve the mother
and the baby and her rights to full  information must be honored. We won't have
to worry about contradictions, we  have to worry about denying her the right
to know and choose.  I am  concerned that if we lose sight of the dyad we
serve, we will become part of the  problem instead of part of the solution.
Evidence based, sure. But even in  medicine their is research evidence and clinical
experience that guide  decisions.  Breastfeeding is not an exact science, it
is what we have  always called it...an art and a science.  LCs should be
allowed to also  work with the art of it even if the science doesn't always
agree...or just  hasn't caught up.

I do not have to recert for a few years.  This has been a very  interesting
discussion for me to follow and the outcome will likely determine my  own
future choices about how I practice, what I call myself and who I allow to  govern
my foremost ethical commitment to the women and babies I work for.

Take care,
Pam MazzellaDiBosco, IBCLC, RLC

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