I apologize to everyone who is burned out on this topic. I do think it is a
very important one for breastfeeding advocates to discuss.
I have done alot of research about becoming a lactation consultant. I have
several concerns about what I have discovered:
1) There is no control of any terminology other than IBCLC. It is legally
OK for anyone to call themselves a lactation consultant, educator, guru,
whatever.
2) There is no well defined practice area for IBCLC/CLXs: there is no
legal description of what she can and can't do. For example, if I were a
physician IBCLC, it would be acceptable for me to examine breasts and baby's
mouths, to prescribe treatment via medications or herbs, BUT, as a non
MD/CNM/NP breastfeeding helper, getting an IBCLC does not make it OK for me
to start doing these things. Part of the big confusion in this field is
that what a surgeon can do is not the same as what a physical therapist can
do, is not the same as what a social worker or peer counselor can do.
Getting the IBCLC credential does not empower one to do everything else
other IBCLCs can do. This is different from other fields where all
practitioners with the same credential have a comparable education, training
and scope of practice.
3) I am really confused by the impression people seem to have that once you
are a credentialed LC who is not a health care professional, you can
recommend herbs (prescribing) or do suck training (invasive exams), etc. I
do not think this it is professional behavior for un-medically trained
people to start doing these things. On the other hand, I am equally
bothered by the attitude I hear from some that only medical professionals
should know/give breastfeeding information and support.
4) I am peeved by the impression I get that some IBCLCs don't want anyone
else to have the right to call themselves a CLX. As a business woman, I
have to say that this smacks of monopoly. (In the US, at least, we are free
market culture...the idea that officials of a professional organization get
to tell other organizations they can't give a comparable credential is
reminiscent of the past grossly unfair control the AMA exerted over
midwifery and alternative health providers.) Every professional who
should care about breastfeeding is not going to willingly subject themselves
to a grueling, expensive test to prove it. These CLX courses seem a way for
many people to show their special interest and expand their expertise in
their own field.
5) It seems to me that there is a move afoot to create IBCLC/CLX as a NEW,
stand-alone profession. Again, as a business person, I think it is bad
timing to launch a new medical field and compete with the shrinking medical
reimbursement dollar. Instead, lets offer people ways to show their special
interest and training in breastfeeding. Certification just like the CLXs we
are discussing is the RAGE in the business industry. Doesn't that make it
beneficial to the world of breastfeeding as a whole? We need to look
outside the breastfeeding world for parallels in other fields as to how to
handle this.
5) Bottom line: if we really want breastfeeding to become the cultural
norm, we are going to need the help of every interested society member, as
well as the medical professionals, paraprofessionals, clerk/typists,
janitors, WIC clerks, etc. Let's find a way to embrace the professional and
credential diversity of those who care, and not push away those who are
trying to do their best to help EVERY woman to breastfeed her babes.
Lots of opinions! Thanks for listening,
Marci Clark
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