I'm going to combine replies to multiple people in this one post; hope
it's coherent:

Marsha said yesterday: <<I think that all these issues are a reflection
of 'step one' in getting breastfeeding on-track
in the U.S. (which is where the stats come from, I assume?) >>

I too am pursuing a Master's in Public Health and when I worked up the
same numbers a couple of months ago (for one of my MPH classes) that
Susan shared with us yesterday I got my numbers from IBLCE, here:
http://americas.iblce.org/factsandfigures.php. What I said about WIC
(serving 45% of US infants, 2 million **PER MONTH, wow, I left out those
2 important words yesterday!** in fiscal year '04) I found at the USDA's
site, here:  http://www.fns.usda.gov/wic/aboutwic/wicataglance.htm and
http://www.fns.usda.gov/wic/WIC-Fact-Sheet.pdf.


Again from Marsha: <<Pushing the health advantages HAS worked, to this
point at least.  It made people,
professionals and parents, pay attention to the issue.  Likewise, we
needed staff in hospitals to help women get started because there were
so many women being sabotaged in their efforts to breastfeed in the
early days after birth.  It's not a question of why we have those stats.
To me, it's a question of where we go from here.>>

I don't disagree. I was trying to suggest where we go from here, and
tying the current status of breastfeeding in this country (high
initiation, low duration) to - among many other probably more important
factors, granted - the lack of LCs *outside* of hospitals, and in
particular within WIC, which serves 2 million low income infants per
month, nearly half of all babies in this country. 

In other words: women need us, my friends. They're out there right now,
well out of the hospital, needing help. And we're not there, for the
most part. We're in hospitals almost exclusively. Time to spread the LC
wealth :-)

Now on to Ann Marie, who I think is correct when she says that we've
discussed this issue before. She said:

<<This is a sore point for me as the WIC I work with as a Peer Counselor
does not "have funding" for a IBCLC, even
though I AM one.  So what they get is a REALLY over-qualified Peer
Counselor. :(  We serve THREE counties.>>

Amazing. You have my sympathies!   


Round Two from Anm Marie: <<I can't afford a membership to ILCA!  I need
to figure out how to afford
CEUs!
So.....for WICs to have more IBCLCs, they need to actually decide to
employ
them. :( >>

Short, to the point and dead-on accurate: for WIC to have more IBCLCs,
they have to decide to employ them. I think the point has been well made
to WIC that PCs are important. They *get* that. They don't yet get that
when said PC encounters a mom with, say, breast reduction surgery or
bleeding nipples or fill-in-the-blank, SHE NEEDS TO BE ABLE TO REFER HER
TO AN LC!  One that the WIC mom won't have to pay for, since 9 times out
of 10, she can't. Sorry for shouting but this makes me nuts. We have
great PCs here in Miami; one of the things that makes them great is they
know what they can handle and what they can't. 


Then Laurie pointed out that, yes, LCs need to make a living:  <<As long
as these situations exist, I think IBCLCs will continue to choose
hospital practice more often. I commend ILCA and all the LCs working
with them,  for all their efforts towards remediating these issues.>>

Agreed. We may be martyrs for breastfeeding but we're not supposed to
have to be ;-)  LCs will not restrict themselves to hospitals if they
don't have to.  (And wouldn't it be nice to have a choice? To have some
competition for your skills and a variety of settings within which to
use them?) It is often commented here (present company included) that
most LCs in the USA are nurses. But turn that around: most who wish to
become LCs can see beforehand that it's easier to get a job *as* an LC
if they're a nurse first. So some of this discrepancy is built into the
system, if you get my drift. In other words: if the best prospect for a
well-paying LC job wasn't almost exclusively a hospital one, would so
many of our candidates be nurses?

And I feel the need to point out: yes, we need our hospital LCs! This is
not nurse-bashing. I'm just arguing for more availability of LCs (nurse
or not) past the hospital-experience. Without that, duration rates will
NOT go up, I am convinced.

If you made it to the bottom of this post, thanks for listening :-)


Regina M. Roig-Romero, BS IBCLC 
Senior Lactation Consultant 
Miami-Dade County Health Dept WIC/Nutrition 
Breastfeeding Program 
7785 NW 48 ST, Suite 300 
Miami FL 33166 

(786) 336-1333 x162 
(786) 336-1345 fax 
(786) 336-1336 Breastfeeding Helpline 

Please note: Florida has a very broad public record law. Most written
communications to or from State officials regarding State business are
public records available to the public and media upon request. Your
E-mail communications may therefore be subjected to public disclosure.
Confidentiality Notice: This electronic message, including any
attachments, contains information that may be legally confidential
and/or privileged and is intended only for use by the individual and or
entity to whom it is addressed. If you are not the intended recipient,
any unauthorized disclosure, review, copying, distribution, or use of
the contents of this information is prohibited and may be unlawful. If
you have received this electronic transmission in error, please notify
the sender immediately and proceed to delete it.

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome