Melissa,

You should spend some time at the American Dietetic Association's website, www.eatright.org.  In simplistic terms, the ADA would be similar to ILCA in the lactation world.  ADA *does* have a Scope of Practice which you can find on the website above.  You do not have to be a member of ADA to be an RD, just like you do not have to be a member of ILCA to be an IBCLC, but there are some benefits of membership, should one desire to take advantage of them.

Credentialing is done by a separate entity (which has obvious ties to ADA), the Commission on Dietetic Registration.  Their website is www.cdrnet.org.  CDR is the organization which administers the exam for those wishing to become RDs.  CDR oversees the continuing education process and also administers board exams for some specialty practices, diet techs, etc.  CDR could be compared to IBLCE in some respects, again, in very simplistic terms.

RDs are required to complete 75 hours of continuing professional education every 5 years.  CDR accepts attainment of the IBCLC credential as fulfillment of those 75 hours *once* during the "life" of an RD, so that is something to consider should you wish to do both.  RDs do not currently recertify by repeating the entry-level exam unless they let their certification lapse and wish to re-up.

This is where the waters get a bit muddied.  In the US, 46 states regulate the practice of dietetics and that legislation differs across state lines.  In some states, you must be an RD to be licensed in the state; in other states, you may be able to practice within the scope of the legislation *without* the RD credential.  Credentialing as an RD is a national process, while licensing is different (or non-existent) in each state.

As with many professions and credentials, requirements change and I know that the educational process is under critical review.  Talk to your local university's dietetics/nutrition department head for a better feel of what may be coming down the pike.  You can source those persons at the CDR website.  With technology, distance programs exist and are becoming more popular for the undergrad degree in dietetics.

My humble $0.02 worth about insurance reimbursement...I was involved in the grassroots efforts of licensure and, from the beginning, one of the pushes for licensing within states was to gain the ability to seek third-party reimbursement.  Not all RDs are reimbursed and the battle can be arduous.  Do not go into dietetics with blinders on, thinking that you will have insurance companies pouring money into your coffers.  While much of dietetics practice is "curative", the concept of "preventive" doesn't win brownie points.

Also, please do not forget that there are incredible persons with nutrition degrees who chose/choose to not become RDs (some are on this list).  You need to carefully consider *what* you want to do before you determine what path is best.

From the ADA website:

>>For Registered Dietitian
A Food and Nutrition Expert

EDUCATIONAL AND PROFESSIONAL REQUIREMENTS 

Registered dietitians (RDs) are food and nutrition experts who have met the following criteria to earn the RD credential:

  a.. Complete a minimum of a bachelor's degree at a U.S. regionally accredited university or college and course work approved by the Commission on Accreditation for Dietetics Education (CADE) of the American Dietetic Association (ADA). 
  b.. Complete a CADE-accredited supervised practice program at a healthcare facility, community agency, or a foodservice corporation, or combined with undergraduate or graduate studies. Typically, a practice program will run six to twelve months in length. 
  c.. Pass a national examination administered by the Commission on Dietetic Registration (CDR). 
  d.. Complete continuing professional educational requirements to maintain registration. 
Some RDs hold additional certifications in specialized areas of practice, such as pediatric or renal nutrition, nutrition support, and diabetes education. These certifications are awarded through CDR, the credentialing agency for ADA, and/or other medical and nutrition organizations and are recognized within the profession, but are not required. 

In addition to RD credentialing, many states have regulatory laws for dietitians and nutrition practitioners. Frequently these state requirements are met through the same education and training required to become an RD.<<

Hope this helps.  I wrote this quickly, so all of you other RD/IBCLC folks feel *free* to correct/edit and otherwise jump in to this answer.  While ADA and CDR are far from perfect, ILCA and IBLCE might glean some useful lessons from them...but I digress...

Warmly,

Rebecca DeYoung Daniels, MBA, RD, LD, IBCLC, RLC, OPQRSTUVWXYZ <g>.....and MOM to 5 in KS (also LLLL Reserve)...whose youngest just declared that he does not want to nurse anymore and I was not ready...Kleenex, anyone?













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