BTW, I was thinking about lactation specialization the other day and how, in
my mind, retesting undermines this. If the test only assures minimum
competency, how does one ever specialize? And how do ever know that an IBCLC
has achieved more than minimum competency? Years of experience by no means
guarantee this. In my opinion, retesting is false reassurance and means
little. As for specialization, if you spend years studying a particular area
(say, NICU), you may not need to know much about the other areas, yet you
have to retest on the whole spectrum. What assures your competency in your
area of specialization? And where is any value being placed on
specialization? Personally, I see myself as specializing in holistic
lactation, as the tools I use reflect this, yet very few IBCLCs know much at
all about these things. If I look at our system of retesting, the area I
have
spent so much time learning about, and even pioneering to a degree, is
meaningless for my certification. This makes no sense to me at all. I really
do feel that I am in a field that is ever more alien to me, that reflects
less and less my experience and understanding of breastfeeding and may in
the
end become just one more cog in the wheel of the medical birth machine that
causes so much human suffering.

_----
I think the point is that retesting brings us back to the 'core' of the
subject.  There may be space for specialisation and obviously some people
may be more at home and experienced in dealing with certain areas.  Perhaps
the time will come when there is space for specialisation within IBCLC.
But, the fact is we mustn't lose site of the 'core'.  Retesting is a time to
bring back the research and evidence based practice, that can so easily go
to one side when we start exploring 'specialist' areas.  Specialist areas
can be researched and brought within the core.  But what happens for example
when you are working with a mum of a premmie that gets to 3 months old and
has a problem - do you say 'well actually I only deal with premmies, i'll
send you to someone who deals in older children'?

Pam Lacey IBCLC




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