I have been following with great interest the recent discussion on
eligibility pathways and practice hours.  I have just completed the BSC home
study follow-up course which includes a clinical practicum.  To complete the
course we need to follow two nursing dyads (with a problem related to BF)
from before delivery to six weeks post-partem.

Although I have four years experience as a breastfeeding counselor, two years
experience as a pediatric dietitian and I've completed the BSC 8-day course,
 I did not feel well qualified to assess BF difficulties and offer
recommendations.  I need more practical experience.  There are so many things
I've learned about - read about, seen videos on, etc. - such as cup feeding,
finger feeding, using the Dancer hold for a premature infant.  But I've never
observed them or actually assisted a mother to do them.

In order to sit for the registration exam to be a registered dietitian one
needs a Bachelor of Science degree in Nutrition plus 900 SUPERVISED hours of
clinical practice.  Although I don't think I would want to complete a 9 month
internship to become a LC, I think that there needs to be some sort of
supervised clinical experience whereby student (or intern) lactation
consultants can gain much needed practical experience.

While I understand the difficulties this presents (cost, transportation,
time, etc), I feel that without this it is difficult to standardize
requirements for an entry level LC.  If we want to be thought of by other
HCP's as the experts in lactation, we need to demonstrate that we are well
trained.  This can best be accomplished through the expert guidance and
mentoring by more experienced LC's.

Rachelle Lessen, R.D. hoping to become IBCLC this year