I have been reading lactnet for quite awhile but have
never posted before. I agree with all the frustrations
shared about the lack of clinical qualifications to
become a lactation consultant. I have an addiitonal
frustration - the lack of opportunity to become
clinically competent.

I am woman interested in becoming a lactation
consultant. I have a graduate degree in nutrition. I
have done about 100 hours of lactation-specific
education. I have done several infant- and
child-development courses. My current professional
specialty requires thorough understanding of anatomy,
kinesthetics, and learning through physical
experience. I have shadowed all the IBCLCs in our area
who will permit this. I feel that I could pass the
IBCLE exam easily (I am a good test-taker). I feel
that with my background I could be a really effective
LC. I am passionate about breastfeeding. 

BUT I am beginning to feel that becoming an LC is not
possible.

The problem for aspiring LCs in my areas is
two-pronged:

*You can’t get hours toward taking the exam
*You can’t get clinical supervision in order to become
competent

There shouldn’t be a shortage of supervisors. In my
area breastfeeding is (wonderfully) widespread. Every
hospital has several LCs (almost all IBCLCs), There
are ten PP-LCs I can name with thriving practices
within 10 miles of my home.

The hospitals within 40 miles of my home only allow
IBCLCs (and RNs) to work with moms and babies. Our
local WIC requires either an IBCLC or a peer counselor
(which I don’ qualify for). Hospitals and WIC won’t
even allow volunteers to do the straightforward
teaching or brestfeeding triaging. LLL doesn’t need
leaders in my area; plus I don’t subscribe to every
point on the LLL agenda.

This situation is a mixed blessing. It is good that
the IBCLC credential is valued, and it is certainly
good that hospitals and agencies are trying to make
sure that only qualified people are helping moms and
babies. But how is a non-nurse supposed to join the
ranks?

I have finally found a volunteer position where I work
about three hours a week as a breastfeeding counselor
or a local social service agency. I am the only person
in this agency with any breastfeeding knowledge.
Frankly, I am nervous every time I see a mom with a
problem.  My breastfeeding counseling has never been
evaluated by an experienced LC. Most of the moms I
work with do not have health insurance; nor do they
have the money to see qualified LC. If I can’t help
them, they will be on to bottles. But I can’t find
anyone willing to do clinical supervision, even when I
offer to pay them.

In my areas, most of the practicing IBCLCs are in
their 50s. I wonder who will replace them when they
retire?

It seems to me that we have a real problem if any
half-interested nurse can become an IBCLC, but it is
not possible for a passionate, well-educated,
well-prepared breastfeeding advocate to even get
close.

The only way I can see out of this situation is
organized clinical education, similar to rotations in
nursing school, or internships for LCSWs, or
supervisions for PTs. It seems that every other
profession that requires interaction with patients
requires supervised clinical experience. And this
experience is readily available to those who have
completed a specified preparatory program. Why should
we be different?

Any thoughts?

Mary Horrton



		
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