I can think of nothing more vital than having clinical observation hours for
aspiring LCs provided by experienced LCs.  While we need the academic and
lecture format for learning "the bones of the body", we need to value the
immense expertise of our members who have been out in the trenches for 12
years or more doing the day to day work of managing difficult lactation
situations.  The wisdom this experience has engendered is like a vast
library.  We don't dare neglect to use this, as I believe it consists of our
real capital as a profession.

I will never stop being grateful for the generosity of Kittie Frantz and
Chele Marmet, who were the first "real" LCs I knew.  It was so exciting for
me that they let me watch them work.  From them I learned that there were
skills and techniques that I could immitate and which would allow me to
become more effective.  Academic theory must be in place, of course.  It's
inexcusable to not do our homework on the physiology and anatomy and "bones"
of our specialty, but we must recognize that all other professions have
internship segments where style and technique are critiqued by experienced
mentors.  Somehow that component HAS to be added to our currently haphazard
methods of training LCs.

 The real problem is, of course, that there isn't one pathway which has been
agreed upon as to what an LC should master for proficiency.  We have the
exam, which, now that I have worked on it myself I am pretty impressed by.
But in my opinion we still need to be working collectively on quantifying
the body of knowledge we think an LC should be the master of.  I take my
hats off to Judi and Candace at BSC for working on doing this. And for Linda
Smith and all the others who have labored at this effort over the years.  I
continue to hope that this effort translates someday to a curriculum which
could be studied at universities.  As much as many would like to see LCs
tied to nursing, the truth is that we'd get more respect and have more a
"mystique of expertise" if we were a free standing profession like OTs PTs
and RDs. A degree plan would assure that anyone who graduated -- whether RN
or not -- would have a body of knowledge and practice behind the title which
would be consistant and recognizable by all as real expertise.

I would like to call for an opportunity for some real discussion on how this
effort could be moved forward.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html