Learning theory describes the process of moving from being a novice to an
expert.  Novices are rule driven.  Rules provide the safe structure within
which to make decisions when the individual lacks experience.  As experience
is gained, learners gradually move in the direction of using the rules as a
jumping off place -- modifying them according to the unique situations
presented by each client.  Experts, with years of experience to draw from,
have what amounts to an intuition about situations.  It is based on an
ability to synthesize all the information, filter it through all their
experience, and come up with solutions which may sometimes appear to
completely violate the rules they started out with.

Dancers are like this.  They have to practice the basic steps forever before
they can appear to soar effortlessly. If they are lucky, they have a strict
teacher who won't settle for sloppy footwork.

For LCs, the basic steps are reading the physiology of lactation, trying to
understand the physical rationale of basic positioning (which is still quite
poorly understood by many)and they must cont. to be hard on themselves about
not knowing enough. Without that push, one can never gain expertise. LCs
need to read outside of lactation, too.  We need to study counseling
techniques, esp. attachment, grief, sexual abuse and eating disorder
literature.  We need to read in the biochemistry lit. so we understand the
science.  We need to read the physical therapy and speech path. lit so we
understand oral-motor function.

We will never be treated as a real profession unless we are serious about
becomming and being recognized as experts.  Everyone of us is a pioneer in
our community, and we represent what it means to be an LC.  It is a big
responsibility, and we can't cling too closely to the rules forever, nor can
we claim expertise without putting in the hard work it takes to get there.

If I have one fervent wish for us, it is that everyone of us spend an hour
this week reviewing Michael Woolrich's two papers on Suck and Sore Nipples
(the ones in Midwifery) and reviewing Chloe Fisher's work on latching-on
babies.  Why are we still telling mothers to put baby in crook of the arm
when that is too far towards the side of the body, causing baby to "look
down" at the nipple? This collapses infant airways.  Baby won't go on this
way, leading nurses to shove on the head, further collapsing throat,
traumatizing everyone.  Baby must be at mother's midline (head on wrist) so
baby can "look up" at the nipple with head slightly extended.  Opens
airways, allows for wider gap, and will position jaw closure over
lactiferous sinuses rather than on the nipple, which causes pain, poor
emptying, poor intake, and all the iatrogenic causes of early lact. difficulty.

End of rant.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html