Nancy writes:
> When I was on the IBCLC examination committee our instructions were to
> judge/accept/reject questions for the exam based on what an "entry-level" LC
> would know. I believe, from talking with Ruth Lawrence MD, the current exam
> chair, that the intructions/level is still the same.
>
Keep in mind that what is entry level in 2001 is completely different than
what was entry level in 1991. Our overall knowledge base has changed --
there is far more research out there. So we would expect an entry level
IBCLC Candidate to know a heck of a lot more than the person who took the
exam in 1991 -- just as those who are taking the nursing or medical boards in
2001 know a lot more than those who took the boards 10 or 20 or 30 years ago.
I was astonished at how much more my daughter knew when she got out of
nursing school than I knew when I got out of nursing school. My OB nursing
text was probably 350 pages. Hers was 2000. The second edition of Lawrence
-- copyright 1985 -- was 600 pages (nearly twice as long as my entire OB
book!!) -- the 5th edition, copyright 1999 -- is 950 pages!
So while the exam is still "entry level" -- the entry level is much higher by
sheer force of the new, improved, and increased information we have. That's
one of the reasons it's a good test of those who are also recertifying at 10
years. If an IBCLC hasn't kept up -- if she's still functioning at the level
she was when she took the exam 10 years ago -- then she will not do well.
She might pass -- but perhaps just barely.
One of the things I expect from a seasoned IBCLC is that her (sorry to the
male IBCLCs -- you are included here, just as women are often included when
'he' is used) what I call "Nancy Drewing" skills are honed and sharpened.
It's the part of us that sees a baby who isn't gaining, and doesn't just
increase the baby's intake, but tries to figure out WHY the baby isn't
gaining....is it a mom issue, is it a baby issue, is it a combination of
both. What are we going to do about it? How can we help the mom? The baby?
and preserve the breastfeeding in all of this. What is the underlying
mechanism? Is it something as simple as not feeding often enough? Or more
complex, along the lines of a maternal diagnosis of PCOS? It requires
thinking outside the box -- daring to be more than just a breastfeeding
assistant and be a true lactation consultant.
We can't be afraid to ask questions -- to pose issues -- to suggest unusual
alternatives. While we often say we don't want to medicalize breastfeeding,
we have to keep in mind that we are dealing with medical issues that may
impact breastfeeding. So we have to know and understand what these are, and
what can/should/needs to be done about it.
Lactnet is a great resource. And I've been using it in another way (OK, list
moms -- true confession time): when I get a call from someone that wants to
become a lactation consultant; someone who nursed her babies and thinks this
would be a great new career change or a good hobby to get into; or someone
who tells me that she doesn't understand why she needs any sort of a college
education -- just a basic lactation course....I ask her to sign up for
Lactnet. I tell her I want her to lurk for a week or two weeks. She isn't
to say anything, but she's to carefully read all the posts about the complex
breastfeeding problems that we run into as lactation consultants. While I'm
excited that she wants to help mothers breastfeed, I want her to understand
that being a lactation consultant is more than being a cheerleader -- and
there are reasons why there are new educational standards being put into
place.
I agree with Barbara Wilson-Clay that we need to standardize the education.
I want to see it in a unversity setting (at the very least, at the community
college level). There is far more to lactation than I can teach in a week
long course....but that's a whole 'nuther post and issue, and more than you
want to read right now.
Jan Barger, RN, MA, IBCLC -- Wheaton IL
Lactation Education Consultants
www.lactationeducationconsultants.com
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