I want to add some more to Barbara Ash's post and the previous discussion about if the IBCLC certification is "an add on certification." I think in the early years of the exam, people were taking it to become professional LCs. They intended to practice as such. 

Things have changed to where now many are taking the exam to further their already chosen career, such as nursing or WIC nutritionists. (Perhaps the boss wants an IBCLC on staff.) Rather than the person taking the exam with the single goal to practice as a lactation consultant. 

People looking for that "add on credential" approach this business differently than those looking to use the IBCLC designation as a career/profession. They aren't as knowledgeable about the professional and/or business aspect of things. Being IBCLC is not a business to them. 

It could also be that their are not enough jobs for IBCLCs to work as such, rather than just an "add on credential" to make the work place look better. (Places where the IBCLC has a main job duty of something other than direct, hands on, breastfeeding help.)

The public is unaware of the different varieties of LCs -- it is all the same to them. But the type of care, or skill level and knowledge base, is usually different -- and sometimes widely different-- among our different categories of LCs. 

Kathy Eng, BSW, IBCLC

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