YES, Gonneke. This is EXACTLY what I think.  My dream course of study would include OT, PT, ST that intersects with lactation, psychology, counseling, business and economics, philosophy, writing, research and statistics, of course all the a&P, medical terminology, and lactation courses.  At least a bachelor's degree with internship, mentorship, and a project thesis (which I had to do for my bachelor's and did on improving relationships between lactation consultants and physicians).

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of gonneke van veldhuizen
Sent: Saturday, August 13, 2011 3:04 AM
Subject: Re: IBLCE requirements

Dear breastfeeding minded lactation community friends,

I want to chime in on the IBCLC requirements discussion once more with a case I attented yesterday. Mom agrees to share her story for educational purposes.
Babygirl is ab. 17 wks old now and mom has had pain all 17 of them. Pain is described as burning, like chafing-wounds. Unsuccessfully treated for thrush as well as dairy allergy (based on symptoms as clicking while drinking, loosing vacuum, fussyness, colic). Seen by 2 midwife-IBCLC's and 1 MD-IBCLC. And one lay counselor from a LLL-like organisation who referred her to me. I spend half an hour with the 2 of them (half of it exchanging smiles with babygirl, untill she became very angry at me for peeking and prodding in her mouth) and found a high-domed palate, a tongue that did have no signs of classical akyloglossia (and was thus dismissed by the MD-IBCLC and babygirl's ped), but seemed glued to the bottom of the mouth. Tongue function was severely decreased, only move forward a bit, more stretched out at the frontal half to extend to just over the bottom tooth ridge, and cup while laying glued to the bottom; and a rather severely tied upper labial  frenum. Mom's nipples with no apparent bruising, but always feeling like heels in new shoes.

So, I'm not a midwife, not a nurse, not an MD, just a Kindergarten/groundschool teacher and IBCLC. But I have a good set of eyes (well, with contacts and reading glasses, but hey ..), an inquiring mind and a good sense of logic. Why did it take me far less than half an hour to find out what all the medically trained HCPs couldn't? Where does having a medical oriented training, knowledge about medical charting and universal precautions fit in to make me a better qualified IBCLC? And mind you, this example is just one example of many similar cases I've seen int the 20 years of my experience.

Musing further I think for IBCLC to been seen as a true stand-alone profession maybe it should be embedded in formal professional education like all bachelor-level professions. In my country all bachelor level professions (like, but not limited to nurses, midwifes, physical therapists, teachers, pedagogues, dietitians, ...) have a 4 year formal education including extensive internships in different settings, with minors in neighboring studies, concluded with a paper/thesis/study. Lactation consulting would fit perfectly well in such a schooling system. We could even put some medical terminology in it and some universal precaution. But also loads of pychology, sociology, antropology. I'd close my PP to be a professor in such an institute! My classes would be basic lactation consulting skills, and anatomy and physiology of normal lactation of course.

Warmly,

Gonneke, IBCLC in PP, LC lecuturer, dreaming in southern Nethelands


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