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From:
Jacquie Nutt <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 8 Aug 2011 18:08:56 +0200
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Dear Lactnet Colleagues

I am very pleased to see this discussion go public!  Oh, I'm not meaning 
that people have been whispering behind closed doors here.  On the contrary, 
I felt that I was the only person who was disturbed about the huge sideways 
jump in education requirements (let alone the reduction in experience 
hours).  In fact, I was astounded that this had passed without comment.  Now 
I am kicking myself that I haven't spoken up before.

I like the change of requiring that the experience and training has all been 
acquired in the past 5 years, which puts candidates on a par with those who 
have the credential and must recertify every 5 years.

It may appear that the changes do not directly affect the  current IBCLCs, 
as we have our credentials already, sucks to the rest (I would never have 
been able to attain mine under these rules).   However I submit that it will 
in the end affect us if our profession becomes more medicalised. 
Breastfeeding and childbirth are not medical problems,  although medical 
problems can arise in both.  Certainly, unskilled practitioners can increase 
the likelihood of issues arising.  However if everyone is relying on Pumps, 
Pills and Providing guidance, the inestimable talents of the mothers and 
babies are lost.

Just a Tale of Two IBCLCs who happen to be friends here.  One came up 
through the ranks of the lay counsellors, the other as an RN.  The RN-IBCLC 
said to her friend, "How CAN you waste 1 - 3 hours with each mother? 
Organise yourself and get through the work."  Now that the RN-IBCLC is in 
private practice, she is changing her tune, I hear, while I quite understand 
how she might have felt that way while working in the hospitals (and do we 
wonder why we private practitioners  have so many pieces to pick up 
post-discharge).

I *hear* that Board too, in that it would like to have other health 
professionals, plus the insurance companies, recognise us.  That would be a 
good thing, right?  In practical terms, outsiders are NOT irrelevant.   Just 
like, "Take these 2 aspirins and contact Physio Phyllis for your sore knee." 
or whatever referral is given to another health professional, we would like 
to hear, "You need to see Isobel IBCLC for your breastfeeding issues." 
Until we are recognised, we are going to have under-educated health 
professionals continue to give babyfeeding advice to mothers, and we know 
where that has got the modern baby.

However I very much hear on the ground locally (and now internationally) 
that the courses are almost impossible to find (let alone assess for 
usefulness), as well as expensive, and this is on top of other courses and 
books and being done during "spare time"... with little recognition or 
recompense from employers.   And some of the courses seem so random... like 
"occupational safety".  What does that mean... Universal precautions?  Use 
gloves when examining?  Tell someone where you are going when doing a home 
visit?  DUH.  I need a certificate for that?   It's called 'survival of the 
fittest', dears - dumb actions weed out the idiots.  (Perhaps I have missed 
something with occupational safety....)

I am very confused as to how long a course is actually required.  A semester 
of this and that.... Well, not all countries know what semester-long courses 
are. It sounds like 6 months of work, but I gather it may be as short as 20 
hours. I would like that specified.  In my university days, you worked for 
10 months and passed or failed the year, no credits, so I have no idea how 
many hours must be spent on each course.  Are tertiary institutions all 
equal? - of course not.

I fear that the counselling skills of (eg) LLL-trained people have been 
utterly discounted, in favour of "the hip bone connects to the thigh bone" 
training, plus all the potential "this pill does great things for people" 
mindset of such training. In the end, I believe that medicalising the 
profession disrespects the instincts that mothers have, in favour of experts 
spouting advice and guidance and acting like the Saviour.  I hate this.... 
and at times would rather not be an IBCLC than be connected with such a 
mindset.

My goal at all times is to empower mothers, and direct them inwards and to 
their babies, with as much technical knowledge as they need, to be sure. My 
professional Scope of Practice directs me to refer when I am out of my 
depth, eg to an SLP-IBCLC or RD-IBCLC or PT-IBCLC, or whatever is required. 
I might quite like to hear about their skills, without wanting to do a 
semester-long course.

I believed that the exam would assess my skills...though second time around 
I was very disappointed at how little it tested of what I have revised. 
Perhaps it's the exam that needs re-visiting, and not the basic 
credentials - in fact, I'm pretty sure of that, and that's a whole 'nother 
discussion: the shortfalls of a multiple choice exam, no matter how wordy or 
convoluted.  I reckon that these new criteria could be used for those who 
want to go towards an IBCLC (Advanced) credential PLUS a practical 
assessment, but not as our entry-level assessment.

[If the ABRSM can affordably send a practical examiner to assess every music 
exam candidate in the world, why not IBLCE?]

I do agree with Patricia and Pat that we MUST contact IBLCE with our 
concerns, if we have them.   I was going to offer to collate replies and 
send them in.  However it will be better with an onslaught of responses. 
Please don't merely copy to [log in to unmask], but also to the other regional 
offices in Europe and Asia-Pacific ie [log in to unmask] and 
[log in to unmask] .  I would welcome IBLCE putting across their thinking to 
IBCLCs and candidates worldwide.

Feeling strongly in South Africa, where 'ignorance' is evidently making me 
feel tetchy.  This reminds me a little of early women's lib... instead of 
highlighting our strengths, we tried to meet the opposition on THEIR terms).

As always, with the good of mothers and babies in mind,

Jacquie Nutt IBCLC
(2 exams, top tier scores both times despite knowing nothing of 
'consequence'. And admitting that there is always much to be learned.  And 
now taking a deep breath)

             ***********************************************

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