The discussion re practice hours brings up a subject about which I feel
strongly.  However, what I am about to say should is in no way meant to
condone cheating on the current requirements.

I think the 4000 hours of practice currently required is ridiculous.  I
legally met that requirement by going back through all the years I have
worked as an OB nurse helping mothers breastfeed their babies--never
mind that probably at least 9/10 of that time was spent in suboptimal
practice based on what I knew at the time, much of which I now know to
be "wrong."  Nearly all of my hours were obtained before my lactation
educator course.

In contrast, there is a nurse with whom I work who took her basic
lactation course within a year or two of having begun OB nursing.  She
is an excellent resource for our breastfeeding dyads.  We rely on here
heavily when she is working and I am not there.  However, she can't even
consider taking the exam because of her lack of practice hours.

It seems to me that it would make much more sense to require 1000 hours
unsupervised or 500 supervised hours for everyone regardless of
educational background.  All the hours should have to be after a basic
course AND a STANDARDIZED exam.

Reducing the number of hours on the basis of supervised hours is a great
step in the right direction, and I commend IBLCE for taking that step.
However, I believe we could rethink this as well.  Why does the IBCLC
need 5 years of "experience"?   The way the requirement is currently
written according to my understanding, it is really 5 years of "lapsed
time."  A smaller number of years of actual experience ( especially
full-time)  would be more appropriate.  Again, an exam might make sense
to make sure the person knows something about teaching "interns" and not
just how to do consultations.

I understand that ILCA is looking at standardization for CLE and CLC
courses and that IBLCE is looking at educational requirements; I commend
them for so doing.

Just my .02.
Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA