I am somewhat behind in reading my Lactnet posts due to a life changing event
that occured three weeks ago. My daughter gave birth to our first grandchild,
Haley, with grandma Marsha having the priviledge of wittnessing the event.
Dr. Shannon graduated from veterinary school on Sunday May 20 (in very early
labor) and delivered Monday evening. Our son-in-law rushed her to the
hospital bleeding heavily. She was met there by her midwife who calmly and
beautifully orchestrated the labor, free of epidurals (bless midwives) and
caught 7lb 4oz Haley who was two weeks early. Within 65 minutes, Haley
crawled to the breast and latched on, just like in the research by Anne-Marie
Widstrom. Shannon's midwife and labor nurses (bless midwives and labor
nurses) were in no hurry to do anything other than let Haley go to breast. My
point in all of this, other than to brag, is to remind myself that birth and
breastfeeding support is a team effort. The hospital has an IBCLC who has
worked with the labor nurses and facilitated their knowledge about this
special time.

We have talked a lot about credentials and I just felt the need to look at
ILCA's Standards of Practice for the IBCLC. If LCs wish to be a profession,
there are a number of items that need to be in place. We have an exam, we
have standards of practice that an IBCLC is supposed to be able to use as a
model for safe, responsible practice. ILCA is in the final stages along with
IBLCE of putting into place the International Lactation Education
Accreditation Council. This Council will be the accrediting body for LC
preparation courses. This protects both prospective LCs and the public. It
also discourages the granting of letters or "certification" for attending
courses. I get many calls from insurance companies, hospitals, and other
employers about the differences between these letters. Some hospitals like to
hire someone who is not IBCLC and pay them $6-7 an hour, claiming in their
marketing materials that they have a full service lactation consultant on
staff. This deceives the public and makes lots of risk managers nervous.

At a meeting of the Course Directors at a previous ILCA conference, ILCA's
legal counsel advised all of the people administering courses that if one of
their graduates is involved in substandard practice that the attorneys were
beginning to hold the training course responsible. These courses do not have
mandatory continuing education, do not have recertification by exam, do not
have requirements for any type of clinical practice experience, do not have
any means to remove an unsafe practitioner. Many of these courses offer
outstanding education. It would be so much less confusing if we could unite
in our efforts as a team and not get caught in the bind that the nursing
profession is in in the US of having three pathways, one exam, total
confusion, and no voice at the policy tables.

Grandma Marsha Walker, RN, IBCLC
Weston, MA

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