Liz wrote: "this is entirely different from the issue of offering *support* 
to a breastfeeding mother -- who may simply be traveling the pot-holes of 
new motherhood -- and offering expert consultative advice to a mother who 
needs someone who truly understands human lactation (think breast surgery, 
frenulum issues, PCOS or infertility history, premie baby, to name a few). 
I'd say any IBCLC worth her salt can offer any mother BF *support.*  But is 
the reverse true?  Do mother-to-mother counselors have the clinical training 
(and professional liaiblity insurance!) to offer care plans for those 
complex situations?"

Liz,
To answer your question I would have to say "it depends."  Mother-to-mother 
counsellors have different levels of expertise as do those with the IBCLC 
qualification (and let us not forget that many breastfeeding counsellors 
have the IBCLC qualification). Being someone who specialises in an area that 
many consider complex (relactation/adoptive breastfeeding) I come across 
women on a semi-regular basis who have not been assisted by IBCLCs (not that 
uncommon for them to be completely fobbed off) and I also come across women 
who have been given great "expert" assistance by mother-to-mother support 
counsellors. My experience with both IBCLCs and breastfeeding counsellors 
leads me to state that I do not believe that any assumptions can be made 
about level of expertise based on whether someone is an IBCLC or a 
mother-to-mother breastfeeding counsellor. I think that lots of 
breastfeeding counsellors would be offended by the assumption that they do 
not truly understand human lactation.
Karleen Gribble
Australia 

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