Sometimes I think that breastfeeding work needs to be returned completely to
the mother support people. However, these fine women do receive training in
breastfeeding normalcy, problems, and counseling. They have a medical board
and extensive libraries and an organizational hierarchy. I am speaking of
LLL which is the only mother to mother network with which I am somewhat
familiar. These are not "just" moms helping each other. There is an
organized format. This is not a way that a woman who wants or needs paid
employment could earn a wage, however.  I came into the profession from my
work as a nicu RN and so I would not have entered this field thru mother to
mother networks.
"Lactation consulting" could be the profession that does not replace the
mother to mother network, but is meant to deal with more complex dyads. I
believe there should also be a very organized system of training. It should
be done with specific coursework, in classroom settings or some online.
There should definitely be a clinical/mentoring portion, and definite
objectives met. The certification exam would be taken at the end, or
licensure, or both. This path would enhance job security for LCs, would
create jobs for LC mentors and instructors, and would remove the "non-RN"
barrier. The LC could work in a hospital setting, a public health setting, a
private practice setting, as other health care workers do.
I respect the opinion of some who believe that this places the LC too much
in the medical model. However, if LCs themselves create the organization,
the schools, the objectives, and the pathways, then the training and
education would not be run by the medical establishment.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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