Lynn Shea wrote: "and seeing a number of these babes and realizing that the
"bad" advice is now being given by the LCs in these institiutions!"

Lynn, I agree wholeheartedly about the "bad advice" parents are being given,
esp. re: high-risk babies. It's really, really frustrating! But in the last
year or so, I have become increasingly aware that often the persons being
represented to us as "the LCs in these institutions" are not "LCs" at all,
of any accepted level of certification or preparation.

As the notion of professional "lactation consultants" becomes more popular
and widely accepted (vs. the old "Why on earth do you need a 'professional'
for that - there's the baby, there's the 'boob', just put 'em together and
if it doesn't work right away, just give formula" way of thinking), I think
a couple of things are happening:

1)Because breastfeeding is (slowly, yes) gaining acceptance as being
important, more and more doctors' practices and hospitals are eager to be
able to offer "lactation services" to their clients. Unfortunately, though,
I've noted a tendency for them to send a staff member or two (usually a
nurse who has expressed interest in and support for breastfeeding) to a
conference or an extra in-service or two, and then designate that person as
their "lactation consultant". I'm not talking here about any of the various
certification courses that are available, or the differences in preparation
and training, and I don't want to re-open that discussion here; I'm talking
about the nurses and other staff members who are put in the position of
being "designated" as the breastfeeding support person for that practice or
office or department or whatever.

2)Parents are quicker (again, because the whole field is becoming more
acknowledged and widely-known) to call *anyone* they've talked to about
breastfeeding, whether or not that person was even identified to them *or
identified herself as such*, as being "the lactation consultant". Most
people aren't well-informed about the differences. The nice nurse who helped
them get their baby latched on at the hospital, or the supportive & friendly
person at the doctor's office who actually had time to talk with them a
little about their BFing concerns, or the LLL volunteer or Peer Counselor
they were advised to call & talk to on the phone, or the "lady" to whom they
were referred with their questions or whose name-tag had some extra initials
on it, or the IBCLC they consulted and to whom they paid a fee - an awful
lot of people really don't know the difference! (And how would they, when we
in the profession have such a wide range of initials and levels of
preparation and internal disputes about who's "really" a lactation
consultant?!)

I've certainly noticed an increasing tendency among my clients to tell me
that "the other lactation consultant said...". When I ask who that was, they
may tell me the name of a nurse in the hospital who I happen to know is a
great BFing supporter and very knowledgeable & skilled but makes no claims
to have any kind of certification as an LC at all. But someone at the
hospital told her the "breastfeeding expert" would be in to talk to her, and
then in came this helpful nurse, and as far as that mother is concerned,
that was the "lactation consultant". Or it might equally likely be an office
nurse or a WIC nutrition aid who has no particular education or training or
even interest in breastfeeding, but who has been designated the "lactation
counselor" because The State requires that *somebody* on staff be one, or
because a practice wants to be able to tell patients that yes, they have a
"lactation consultant" on staff. It might be someone truly wonderful at
BFing support, it might be someone who was involved in LLL 30 years ago but
hasn't kept up with the field since, it might be someone who has no
particular interest in BFing at all and who I know from personal experience
is grossly misinformed.

3) There is a certain status some women feel in being able to say "my
lactation consultant told me...". I commonly get calls from WIC clients who
tell me that their "lactation consultant at WIC" said xyz - I know for
honest 100% certain that in our local WIC program there is absolutely no one
who would represent themselves as being an LC. There are a couple of
nutritionists who breastfed their own babies, who care deeply about the
importance of BFing, who *wish* they had their lactation consultant (that
would be me - LOL!) back on staff...but they don't call themselves LCs. But
to the mother, a person in a position of authority, or a person wearing a
uniform or a name tag or working in a place where they are expecting to find
expertise, the person who spent time talking with her about breastfeeding is
"the LC".

Cathy Bargar RN IBCLC
Ithaca NY

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