Rachel wrote:
" Mother
 to mother groups are IMO invaluable, to support the normalcy of everyday BF.
 IBCLC's should be available to deal with the complicated cases."

This is why I see such a parallel with midwifery. The United States has the highest rate of obstetrical interventions of any nation, yet we have one of the poorest outcomes for infant mortality and morbidity. In nations where midwifery care is the norm, outcomes are far better. Because birth has been medicalized for so long in the West, I think we can learn from it. The WHO is trying to normalize midwifery again, just as it is trying to normalize birth. I think the two go hand-in-hand and to normalize breastfeeding requires normalization of birth.
    But, my point is this. Birth outcomes are the best when midwives are the primary cargivers and they make referrals as they deem necessary to OB's, who are the  specialists. By the same token, if mother-to-mother support is the first line of intervention/interaction for moms, then LC's will be relied upon only when referred to by the mom support folks.
    In practice of course, I would not want to see IBCLC's become as medicalized as most OB's. But, ultimately I am very concerned about the impact our profession, even by its very existence, is having on nursing moms and babies.
Jennifer Tow, IBCLC, CT, USA

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