I don't know what the US Baby-Friendly criteria are, but I do know that in
Norway, which supposedly follows the UNICEF requirements, at least 80 per
cent of the staff interviewed must have taken part in at least 12 hours of
BF training, including guided clinical practice, within the two years before
the date of evaluation.   There is not a requirement that the entire 12
hours be a particular course.  The employee is not required to document
their attendance at such training to the baby friendly evaluators.  In
Norway, anyway, the requirements are the same for obstetricians and for
midwives and for maternity aides.  As long as the employee says they have
taken part in at least 12 hours of continuing ed about BF, it meets the
requirements for the evaluation.

It doesn't take an IBCLC to see that 12 hours INCLUDING guided clinical
practice is about the same as nothing at all.  

Also, I don't think this analogy about doctors, from Nikki's post, really
fits in our case.  "Does one go to see a general practitioner, a medical
resident, an attending, or a board-certified practitioner for some medical
condition? All are licensed; all treat, and all have education and
experience."  All the practitioners listed have the same basic medical
training at the core, and that training is formalized, with an academically
determined entry level, and the teaching institution is accredited by an
independent body.  The practitioners listed differ in their areas of
specialization and in their years of experience and levels of expertise in
their fields.  The differences between them, and between a maternity
services employee who is sent to a five day course by their boss because
they will get a negative report in their personnel file otherwise, and a
mother who spends many many months working to get certified as a peer
counsellor in order to give to other mothers so they can experience the same
empowerment and joy that the counsellor has through breastfeeding, or
someone who amasses 2500 hours of clinical practice breastfeeding and
studies so they can take the IBLCE exam, are qualitatively different.

As long as people who are arranging the training are also the ones awarding
the certification, such certification will be subject to suspicion of
partiality.  That is, it is in the trainer's interest to see to it that
people get certified, because anything else makes the program look bad.  I
think your certification means more if it is awarded on the basis of pre-set
criteria determined by someone other than the institution offering the
training to prepare you to test for certification.  Just my bias!

Rachel Myr (IBCLC, peer counsellor, and midwife)
Kristiansand, Norway

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