I'm also Canadian and have run into some of the same problems Dany has,
although being in a rural area, the competition is less stiff (I was the
only IBCLC within 300 miles for many, many years. Now I'm the only one in
about 100 miles). While I love our health care system, it has created an
attitude of not wanting to pay for services. However, I see this less now
than when I started in 1988, since there have been cuts and some billing has
been introduced.

I know that to be more successful I need to do far more marketing. That's
the basis of a successful business.

 Right now what "brings home the bacon" for me are inservices and working on
a prenatal nutrition project. This is providing excellent contacts for me
and also the opportunity to talk up breastfeeding. I took a good, hard look
at my practice this fall, figured out just how many babies are born in my
entire region (which would involve 4 small hospitals, including Peace
River's, within a 1 hour driving radius) and saw that there just weren't
enough to keep me busy even part-time. That was when I looked for
alternatives and found this prenatal program.

So, for budding LCs in non-urban areas, I say--don't expect to make a
living--but you CAN expect to provide a fabulous service for themothers who
find you and are willing to pay for your service. I would have a very hard
giving this up, but also need to look at financial realities. If I can keep
finding other projects to contract my services to, I think I'll be OK. This
is the first year I've worried about it because I was educating kids at home
and didn't have time to get busy. Our youngest decided to attend school this
fall (grade 7) so then I needed to take a look.

Leslie Ayre-Jaschke, BEd, IBCLC
Peace River Breastfeeding Clinic
Peace River Alberta, Canada