Dear Jennifer, I agree with you.  I hear this from so many mothers, both in
person, and on line. There is no real standard of information. Well, there
may be, in the form of a hospital procedure, or set of standard care plan
recommendations, but this does not ensure that the staff will communicate
these standards, or be skilled at breastfeeding management, or even the
basics.  Some are better than others because they want to be, ... It is
permissible for some to ignore things, to not do things just because they
don't have breastfeeding as one of their focal points, their passions.  Care
suffers for this, often in the early critical days.  It would not be
permissible for a professional not to know how to do good Foley care, or
sterile wound care, or IV management... But it is permissible for
professionals not to be adequate in breastfeeding management skills. It's
optional, and everyone knows it...and allows it to be so.

I think that until we have a profession with a practice component guaranteed
and built in,... We will have this haphazard presentation of ourselves as
skilled professionals.  Nurses have this same problem... With many hoping to
gain the professional tag with less preparation, different schooling, etc.
At least, however, nurses all have a professional clinical component that is
mentored, and they all have to take the same licensure exam.  We don't even
have that....  We have similar arguments, however, about preparation, with
some groups advocating for credentials involving much less than the basic
minimum guaranteed by IBLCE.   Unfortunately, the issues concern power,
prestige, and a lack of support for the professional credentialing
organizations that guarantee a minimum of skill in the area of lactation.

Until support for the IBCLC is focused, and until clinical standards are
ensured with clinical training,  this problem will continue.  I have learned
that various designations do not guarantee quality of information or care.
Not even IBCLC. It's what the person has in total... Training, perhaps
personal experience, volunteer work, and most importantly, belief that
breastfeeding works, and a willingness to back that up with good skills and
evidence based practice.

Kathleen


Kathleen Bruce RN IBCLC
Independent consultant: Lactation
Resources of Vermont, Medela, Inc. Listowner Lactnet listserv
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On 5/18/05 12:43 AM, "Jennifer Tow, IBCLC" <[log in to unmask]> wrote:

> It is just too easy to dismiss this thread by "agreeing" that moms hear what
> they want to hear, misunderstand, etc. How does this allow us to evaluate in
> any way just how well-trained we as LC's really are? The issue of tongue-tie
> is a good one. I happen to see many babies whose situations are complex and my
> clients have often seen several LCs before they see me. I expect that
> structural and oral/motor problems may have been missed (although I do not
> think such lapse in education is acceptable, since such difficulties are so
> common), but I cannot tell you how many tongue-ties are missed
> completely--even by multiple LC's. (As I said this is just one example).
> 
> When I worked in hospital, every single complaint from a mother was met with
> the argument that she must have misunderstood.  Yet, often the instructions
> that she supposedly misunderstood seemed to have been similarly misunderstood
> by scores of other moms and I often personally heard the exact misinformation
> come from the practitioner's own mouth, and often after s/he had been
> corrected in the past.
> 
> I think we do a terrible disservice to mothers and our own profession when we
> respond so carelessly to concerns about inadequate education and even sloppy
> care. We spent so many years complaining about what we absoutely knew to be
> true--that peds and OBs often give highly inaccurate and undermining info to
> moms--yet we want to hide out heads in the sand when the problem comes from
> our own ranks. 
> 
> I think there is a problem and I think it is serious. I'd frankly like to
> address it.
> Jennifer Tow, IBCLC, CT USA
> 

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