Jeanine,

As usual, you have provided us all with much food for thought.  (And it is
FAR too early in the morning to have my brain exercised in such a
manner....bring on more coffee, please!)  However, a couple of thoughts did
pop into my head.

Do LCs need to have a medical background because the entire issue of
birthing, breastfeeding, and parenting have moved from a "woman with
woman"/midwife/community/extended family celebration to a (male)
medical/obstetrician/pediatrician and no extended family model?  (And I don't
want to bring up discussions of the "I would have died if I hadn't been in
the hospital," etc. --- at least not until we get equal billing of the "I
almost died because I WAS in the hospital" sort).  How many women get their
parenting information from pediatricians?  "But my doctor said to let the
baby cry.... start solids now.... give a bottle so he won't refuse it later
on.... etc."  Even parenting is looked upon as a medical issue; at least with
first time parents.  Look at who writes the majority of books on parenting:
 Spock (pediatrician), Brazelton (pediatrician), Sears (pediatrician).  Not
to say that is bad, necessarily, but to point out that is it any wonder
breastfeeding has fallen into the same realm of medicalization?

I don't know that I am any better an LC because I am a nurse with nearly 25
years of maternal-child health experience, but I do know that many of my
clients respond in a more favorable manner when they find out I am a nurse.
 I have my IBCLC certificate framed & hanging on the wall in my office.  I
know my RN license is here somewhere; if someone really wanted it I could
find it.  But it isn't framed & hanging on my wall -- not because I don't
value it, but because I am doing LC work; not RN work in my office.  Does the
fact that I am an RN make any difference when I talk with physicians?  I
don't think so -- at least based on my last experience with a pediatrician &
tongue tie!!  I'm not a doctor, therefore, my opinions don't count.  (A
moment of silence for all the wonderful docs on Lactnet who have MD after
their names, but midwife in their hearts).

Enough of that.  My next question is, how many women in the United States
today are really ready for the kind of commitment that REAL bf takes?  How
many are ready for or are looking for that kind of relationship with their
child?  I suspect not many.  True, there are some -- Thank the Lord for who
they are! -- but I don't think I knew/was ready/understood that kind of
relationship when my first child was born 21 years ago.  I was brought up to
think that children needed to be independent (???!!!) early on, and that
meant sleeping away from the parents, scheduled feeds, crying time -- anyone
want to read a baby book of the era of the 40s? -- and that children should
be seen & not heard.  EZZO comes by his philosophy honestly; it is just the
20's through the 50's dressed up in 90's language.  I don't condone it & I
think it is dangerous; but it has been around longer than he has.  Consider
the following conversation I had yesterday with a client:

C -- "My baby is 13 months old, and I think it is time to wean."
Me - "Oh?  You're not comfortable nursing any more."
C -- "Well, no, I still like nursing, but she's too dependent on me."
Me -- "She's too dependent because she's still nursing."
C -- "Yes, I have to nurse her to sleep at night."
Me -- "How do you feel about that?  Are you frustrated with having to nurse
her to sleep?"
C -- "Well, no -- I don't mind it at all, but my mother in law....."

And there lay the crux of the problem.  What other people think in our
society....  She wanted to know when most women weaned and was VERY relieved
to hear that the WHO recommended a minimum of two years (that's called
skirting the question).  And, I reminded her that (a) Amanda is HER baby, not
her mother-in-law's, and (b) the appropriate time for weaning is when both
she and Amanda are ready for it....  And, she went away, a happy, bf mother.
 But, I don't think most women are ready for this -- and that is going to
take a major shift in our society's view of children, parenting,
relationships, commitment, birthing, breastfeeding, and the assumption that
physicians have all the answers to these issues.

Being an LC requires some medical knowledge.  It also requires a background
in many other disciplines -- psychology, sociology, counseling, parenting,
etc. etc.  I don't think there is any one background that prepares one to
become an LC, though there are many that lend themselves beautifully to it.
 The profession needs to have it's own field of study, just as other
professions do.  At the moment, the educational system can't support it;
there aren't enough of us, or enough of us clamoring to get into the field.
 And frankly, we are one profession that would like to work ourselves out of
a job.  We don't want to have to be needed.....  And, in an all perfect
world, we wouldn't be needed....

Enough for this morning....

Jan Barger