Dear all: Thanks to Gonneke and my husband, I have thought of a variety of ways in which many of us might still be able to continue to practice. My husband pointed out, "you seem to be considering yourself a health care pracitioner". And indeed, I checked the IBCLE website and they do state that IBCLCs are considered "health care practitioners'. But there is no other health care pracitioner that is not allowed to contradict another health care practitioner in a professional and colleagial manner. I really see no difference between what was mislabeled a "lower level credential" that can be misused by desparate hospital administrations to pay less for training and for professional services and what should have been an adjunct profession of equal skills in different areas of "counseling" and the IBCLC. In fact, I think a peer counselor (as many of our dear colleagues in LLL have pointed out) will have more ability to provide information to mothers if the scope of practice remains as is. But, my husband pointed out that in the United States, that food and agriculture is far less regulated. So, he started thinking that if we sold ourselves and "human dairy facilitators" those of us who must work in the United States would be able to place the entire profession under a far more lenient regulatory situation. We might even be able to apply for subsidies along the lines of dairy farmers. We could lobby for protectionist legislation. Why should Norway have the corner on nonpasteurized fresh human milk when the US has more women that could produce a surplus that would be dumped on those poor African women that might have HIV? I'm also thinking (seriously) about marketing myself as a "Personal Breastfeeding Trainer". Definitely not kidding. There are so many personal trainers in Manhattan that it might even yield a higher income than a measly IBCLC. Now if I could market myself as a "Personal Breastfeeding Trianer to the Stars" (which would actually be easy to do if I didn't have this serious problem with a hyperactive gag reflex --- Cathy Genna can you help me out on this one?) I'd actually make a decent enough living that I might be able to move out of my rent stabilized one bedroom apartment. The more I think about this the more I become totally serious about the idea of figuring out how personal trainers are regulated and how to develop a new profession that will help women for long-term breastfeeding in a nonmedicalized manner. Restructuring the hospital environment in the United States is impossible right now given the current state of health insurance and hospital staffing. Since 1999 when I had my son, I am seeing a serious decline in the abilty of in-hospital staff to provide adequate care, however well meaning and well intentioned they are. More and more I get complaints about how women were not able to see the lactation consultant or if they did, the poor lactation consultant had such a workload that she was only able to spend a few minutes with the woman. Most of what we provide is not medical at all. In fact, none of it is. It is listening, comforting, evaluting how to get mom to feel more comfortable and referring (when one is lucky enough to have such professionals available) to breastfeeding medicine speicialists who actually know something about breastfeeding medicine. I am lucky in that I have one trusted breastfeeding medicine specialist that I can call on a regular basis and another realtively new to me specialist that I am hoping to get to know better. Best regards, Susan E. Burger *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET email list is powered by LISTSERV (R). There is only one LISTSERV. To learn more, visit: http://www.lsoft.com/LISTSERV-powered.html