Dear Dr. Johnhny Rullan and staff,
I am writing to provide support for allowing IBCLCs in Puerto Rico to
teach "health care/medical professionals" about breastfeeding and lactation.
Traditionally, schools of medicine and nursing have not provided very much
training to their students in two significant areas -- prevention of illness
and nutrition. In fact, most schools of medicine and nursing provide no
training at all about breastfeeding and other infant/child nutrition issues.
Thus, health care professionals without specialized education in these
areas are ill-equipped to help mothers overcome breastfeeding problems, and
usually recommend weaning instead. This of course, is not the standard of
care to which mothers and children are entitled.
Since 1985, a new field of health care professionals has developed,
known as lactation consulting. The individuals who become Internationally
Board-Certified Lactation Consultants (IBCLCs) have to have in-depth
knowledge of all the various biological, anatomical, physiological and
medical issues surrounding lactation and breastfeeding (including the
transfer of drugs into breast milk, various special issues such as
breastfeeding premature and sick infants, mastitis, and many others), as
well as the social, cultural, emotional, and personal issues surrounding
breastfeeding and lactation. They must have thousands of hours of personal
contact helping mothers overcome breastfeeding problems before they can even
sit for the exam. The exam is highly rigorous, and is based on all the
current research in breastfeeding and lactation.
Every month, the international medical journals publish numerous
articles related specifically to breastfeeding/lactation. It is very
difficult for busy medical professionals, such as doctors and nurses, to
keep up with this research, especially when they may not have learned even
the basics in medical or nursing school. IBCLCs are required to keep up
with the research in order to pass their recertification exams. They also
do so as a matter of professional integrity and in order to best help their
clients.
In an effort to educate medical professionals about any topic, you need
people who have specialized knowledge about that topic. For breastfeeding,
that would include IBCLCs, a few doctors and nurses who don't also have
IBCLC credentials but have had specialized training, and people like myself.
I have a Ph.D. in Anthropology, and have conducted research on
breastfeeding and lactation for more than 20 years. I am not a "medical
professional" -- I am a university professor. However, I have specialized
knowledge of breastfeeding and lactation that can be of immense help to
doctors and nurses who do direct care of mothers and children. I have given
many presentations at conferences where doctors and nurses have earned CME
credits (Continuing Medical Education credits) for attending my
presentations. For example, I have presented at the La Leche League
International Physician's Seminars on several occasions, and doctors and
nurses often attend my presentations at regional lactation conferences and
La Leche League conferences.
In my professional opinion, all IBCLCs should be considered medical
professionals, whether or not they are also RNs or MDs. The IBCLC
credential represents a very specialized, in-depth knowledge of
breastfeeding and lactation in all of its components. IBCLCs are the ideal
people to provide education for other medical professionals about these
topics.
Please feel free to contact me if you need any further information.
Sincerely,
Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology and Nutrition
Texas A&M University
[on leave 2001-2002]
_________________________________________________________________
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