I am convinced that without intending to cause any offence, some
hospital-based IBCLC counsellors passed the exam but do not have enough
focus on counselling and listening skills.
This is not necessarily lack of sufficient training but more a question of
time spent on the ward.  Most BF counsellors have other nursing duties which
according to management should take precedence over the time spent on BF
counselling.  And they do not have the experience of the days and weeks and
months following the hospital stay.

Those of us who work out of the hospital do have this experience and
unfortunately we are sometimes critical of the lack of help the mother got
in the hospital.

But we can only provide quality and ongoing counselling  if we are
absolutely dedicated.  My area is on average not high-income and we have to
keep our fees at a sustainable level  (and for the parents who attend my
prenatal course there is no charge).  My average visit is 1.5 hours with
follow up phone calls which can continue for months - and these phone calls
can last 15 minutes plus.  I try to keep within my own city limits but when
an out-of-town parent calls in desperation after I have given them a list of
counsellors in their area and says nobody is available, I cover that too -
although in my senior years I have learned to ask extra for the travelling
expenses.

There is such satisfaction when we see a mother come through the other end
of all those initial difficulties: sore breasts, poor latching, engorgement,
concerns about milk supply - particularly if you meet her in the shopping
mall months later, sitting happily on a bench breastfeeding.

Wendy Blumfield
NCT Trained ANT Tutor/BFC
Israel Childbirth Education Centre

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