Re: New IBLCE requirements

[Guest guest]

I take your point, Ghislaine. I wonder, though, about the wisdom of changing the

requirements without a curriculum in place. I wonder about the international

exam hopefuls, and their ability to find an appropriate course to study. It

still seems to me that these new requirements will make many LLL Leaders or

others coming from a peer support background think twice about becoming an

IBCLC. I also think there is some learning curve whenever we start a new job,

but perhaps there is some other way to make the curve less steep. Also, in

private practice, perhaps an LC doesn't need to know quite as much about the ins

and outs of how a hospital works as a hospital-based LC. I don't have the

answers, but I was surprised when I heard about the new requirements and

wondered why they were put in place.

Kimberley

Kimberley MacKenzie, LLLC Leader, IBCLC

> >

> > From: popikins <YabbaDabbaDoula1@ ...>

> > Subject: Re: New IBLCE requirements

> > To: @yahoogroup s.com

<http://us.mc818.mail.yahoo.com/mc/compose?to=%40yahoogroups.com>

> > Date: Saturday, May 15, 2010, 7:41 PM

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> > http://americas. iblce.org/ announcing- future-requireme

<http://americas.iblce.org/announcing-future-requirements> nts

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[Guest guest]

In my opinion:

1. The IBCLC should be the gold standard, I don't think there should be further

advanced credentials, I think we should work on pushing up the bar for IBCLC

candidates. Those who want a Lactation credential but don't meet the

requirements should be Lactation Counselors. The way in at the moment is too

broad right now.

2. I think those new areas specified are ones that all IBCLC's should be

proficiently knowledgeable about, but I don't think that putting coursework

requirements is necessarily the best answer. If someone had asked me how to go

about upping the bar? I would say either IBCLE should consider providing those

specific coursework modules online or directing us to providers of those

coursework modules because it's going to be such a hassle for people to find

those specific disciplines and complete coursework. An online course with a

passing grade should suffice for a start.

3. To be sure, I think that there should be a separate " application " challenge

type test, testing Candidates on the new basic disciplines that should already

be in place before considering becoming an IBCLC. Those who pass would go on to

take the IBCLC exam, Or even just an additional section to the IBCLC paper.

4. There should be a skills challenge test added as well, just like with first

aid and CPR where there is a situation and you have to deal with it and are

given a pass/fail grade based on assessing and handling at least 6/8 situations

" correctly " .

The reason I'm favoring modules and/or additional testing over coursework is

that coursework proves nothing, AND some people do learn better just from

reading a book or taking a module than doing coursework. Also getting the

coursework is just going to be a huge hassle. I already had it because I was a

midwife first, so it would have never been a problem for me, but I can see how

LLL leaders etc who really do deserve to be IBCLC's would have a tough time

coughing up coursework, yet a relatively easy time doing a module or reading a

book and then taking a test.

well, that's my $0.02.

>

> I agree with Kimberley and Dee here. The requirements will prevent many LLL

Leaders and other bf counselors from pursuing the IBCLC credential. The best

IBCLCs I know are (or were) LLL Leaders!

>

> It is also another step toward medicalizing breastfeeding, which I think does

a disservice to moms and babies.

>

> I'm disappointed, to say the least. I *would* like to see additional

'advanced' credentials or sub-specialities for IBCLCs.

>

> Another option would be to make the test harder. Or add clinical

demonstration as part of the exam. That could help to test knowledge AND

counseling skills. I do understand how challenging and expensive that would be

for IBLCE to implement at this time.

>

> I have not taken many of the courses that will be required in 2012 and I

scored in the 90s last year.

>

> I would be interested to know how they decided to make these changes. Do they

look at data correlating education with exam performance? Are those with less

education performing poorly? I was equally curious a few years ago when they

made the education 'recommended' rather than 'required'.

>

> I am also curious to know what our colleagues around the world think of these

changes. I imagine in some areas, the education requirements (or lack of access

to this type of education) will prohibit many potential IBCLCs from achieving

the credential, and I think that is a shame.

>

> Healy

> Seattle, WA

>

[Guest guest]

Here's an idea to make it less burdensome for the student: the ones with a background in science have to take a customized counseling and practical course and the ones from the lay background have to take a customized course with the science- which could be fairly abbreviated but include some practical things about how MD practices and hospitals work, and of course, infection procedures. Maybe with a practical in hospital?

Both courses would need to be available by internet, with practicals arranged regionally.

Well, I haven't thought this through completely- probably has a lot of holes in it. We will lose some of the heart of the thing by not admitting lay people who bring a different viewpoint to it all, though.

, LLLL, IBCLC, and former RN

Re: New IBLCE requirements

I take your point, Ghislaine. I wonder, though, about the wisdom of changing the requirements without a curriculum in place. I wonder about the international exam hopefuls, and their ability to find an appropriate course to study. It still seems to me that these new requirements will make many LLL Leaders or others coming from a peer support background think twice about becoming an IBCLC. I also think there is some learning curve whenever we start a new job, but perhaps there is some other way to make the curve less steep. Also, in private practice, perhaps an LC doesn't need to know quite as much about the ins and outs of how a hospital works as a hospital-based LC. I don't have the answers, but I was surprised when I heard about the new requirements and wondered why they were put in place. KimberleyKimberley MacKenzie, LLLC Leader, IBCLC

[Guest guest]

that sounds like an awesome idea.

>

> Here's an idea to make it less burdensome for the student: the ones with a

background in science have to take a customized counseling and practical course

and the ones from the lay background have to take a customized course with the

science- which could be fairly abbreviated but include some practical things

about how MD practices and hospitals work, and of course, infection procedures.

Maybe with a practical in hospital?

> Both courses would need to be available by internet, with practicals arranged

regionally.

> Well, I haven't thought this through completely- probably has a lot of holes

in it. We will lose some of the heart of the thing by not admitting lay people

who bring a different viewpoint to it all, though.

> , LLLL, IBCLC, and former RN

>

> Re: New IBLCE requirements

>

>

>

> I take your point, Ghislaine. I wonder, though, about the wisdom of changing

the requirements without a curriculum in place. I wonder about the international

exam hopefuls, and their ability to find an appropriate course to study. It

still seems to me that these new requirements will make many LLL Leaders or

others coming from a peer support background think twice about becoming an

IBCLC. I also think there is some learning curve whenever we start a new job,

but perhaps there is some other way to make the curve less steep. Also, in

private practice, perhaps an LC doesn't need to know quite as much about the ins

and outs of how a hospital works as a hospital-based LC. I don't have the

answers, but I was surprised when I heard about the new requirements and

wondered why they were put in place.

>

> Kimberley

>

> Kimberley MacKenzie, LLLC Leader, IBCLC

>

[Guest guest]

No, I just read your idea and like yours better!

Re: New IBLCE requirements> > > > I take your point, Ghislaine. I wonder, though, about the wisdom of changing the requirements without a curriculum in place. I wonder about the international exam hopefuls, and their ability to find an appropriate course to study. It still seems to me that these new requirements will make many LLL Leaders or others coming from a peer support background think twice about becoming an IBCLC. I also think there is some learning curve whenever we start a new job, but perhaps there is some other way to make the curve less steep. Also, in private practice, perhaps an LC doesn't need to know quite as much about the ins and outs of how a hospital works as a hospital-based LC. I don't have the answers, but I was surprised when I heard about the new requirements and wondered why they were put in place. > > Kimberley> > Kimberley MacKenzie, LLLC Leader, IBCLC>

[Guest guest]

My concern is that if we are going to add all the additional cost and additional

courses, then we need to reflect that in pay. Has anyone recently done a survey

to look at what the job opportunities are? Growth projections? For RN's and for

non-rn's? What about the calculations about what the cost of all this will cost

a person to become an IBCLC (let's say worst case scenario that you need all

those courses and an internship?).

I teach in a nursing program and I know that all those questions are readily

answered and available for students. I don't know if that information is

available for potential IBCLC's. I also know that in my area, jobs for

non-IBCLC's are pretty scarce and private practice IBCLC's like myself (I'm

inactive right now) don't make nearly enough money to justify these costs.

Barb Cavanaugh

>

> I agree with Kimberley and Dee here. The requirements will prevent many LLL

Leaders and other bf counselors from pursuing the IBCLC credential. The best

IBCLCs I know are (or were) LLL Leaders!

>

> It is also another step toward medicalizing breastfeeding, which I think does

a disservice to moms and babies.

>

> I'm disappointed, to say the least. I *would* like to see additional

'advanced' credentials or sub-specialities for IBCLCs.

>

> Another option would be to make the test harder. Or add clinical

demonstration as part of the exam. That could help to test knowledge AND

counseling skills. I do understand how challenging and expensive that would be

for IBLCE to implement at this time.

>

> I have not taken many of the courses that will be required in 2012 and I

scored in the 90s last year.

>

> I would be interested to know how they decided to make these changes. Do they

look at data correlating education with exam performance? Are those with less

education performing poorly? I was equally curious a few years ago when they

made the education 'recommended' rather than 'required'.

>

> I am also curious to know what our colleagues around the world think of these

changes. I imagine in some areas, the education requirements (or lack of access

to this type of education) will prohibit many potential IBCLCs from achieving

the credential, and I think that is a shame.

>

> Healy

> Seattle, WA

>

[Guest guest]

Until IBCLC is truly a stand-alone credential and I can work in a hospital setting, I don't see why I need to know anything about working in a hospital. (except for some basic stuff to help moms navigate and interpret what happens there.)My 2 cents from a Lay LC perspective Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- Subject: Re: Re: New IBLCE requirementsTo: Date: Monday, May 17, 2010, 12:11 PM

No, I just read your idea and like yours better!

Re: New IBLCE requirements> > > > I take your point, Ghislaine. I wonder, though, about the wisdom of changing the requirements without a curriculum in place. I wonder about the international exam hopefuls, and their ability to find an appropriate course to study. It still seems to me that these new requirements will make many LLL Leaders or others coming from a peer support background think twice about becoming an IBCLC. I also think there is some learning curve whenever we start a new job, but perhaps there is some other way to make the curve less steep. Also, in private practice, perhaps an LC doesn't need to know quite as much about the ins and outs of how a hospital works as a hospital-based LC. I don't have the answers, but I was surprised when I heard about the new requirements and wondered why they were put in place. > > Kimberley> > Kimberley MacKenzie, LLLC Leader, IBCLC>

[Guest guest]

Some hospitals hire non-nurse IBCLC's I think, but it is pretty rare and on a

state by state basis. They are all allowed to hire us, but some just don't

because we are not nurses, for example in Hawaii where I was trying to get a job

in a hospital as an IBCLC and was turned down because I'm not a nurse.

Do you think that if the IBCLC credential becomes more diverse (including better

practical and communication skills and yes also some more medical training) that

more hospitals might consider hiring us?

I think it would help a lot if there was a license available for IBCLC's... but

I may be asking for too much in this century : )

> >

> > Here's an idea to

> make it less burdensome for the student: the ones with a background in

science

> have to take a customized counseling and practical course and the ones from

> the lay background have to take a customized course with the science- which

> could be fairly abbreviated but include some practical things about how MD

> practices and hospitals work, and of course, infection procedures. Maybe

with

> a practical in hospital?

> > Both courses would need to be available by

> internet, with practicals arranged regionally.

> > Well, I haven't

> thought this through completely- probably has a lot of holes in it. We will

> lose some of the heart of the thing by not admitting lay people who bring a

> different viewpoint to it all, though.

> > , LLLL, IBCLC, and

> former RN

> >

> > Re: New IBLCE

> requirements

> >

> >

> >

> > I take your point, Ghislaine.

> I wonder, though, about the wisdom of changing the requirements without a

> curriculum in place. I wonder about the international exam hopefuls, and

their

> ability to find an appropriate course to study. It still seems to me that

> these new requirements will make many LLL Leaders or others coming from a

peer

> support background think twice about becoming an IBCLC. I also think there

is

> some learning curve whenever we start a new job, but perhaps there is some

> other way to make the curve less steep. Also, in private practice, perhaps

an

> LC doesn't need to know quite as much about the ins and outs of how a

hospital

> works as a hospital-based LC. I don't have the answers, but I was surprised

> when I heard about the new requirements and wondered why they were put in

> place.

> >

> > Kimberley

> >

> > Kimberley MacKenzie, LLLC

> Leader, IBCLC

> >

>

[Guest guest]

alas, , perhaps we are asking too much. (sigh) I think things may be changing though. My services are now being covered by a couple of major ins. companies. I'm hoping it's a trend! I did work in a hospital here for a couple of years,(they just called me when a patient needed help so I wasn't doing rounds per se) but I was hired by a very think-outside-the-box nurse manager who really didn't care about upper management. It worked well for everyone till a new nurse manager took over and "cleaned house." it was nice while it lasted. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- Subject: Re: New IBLCE requirementsTo: Date: Monday, May 17, 2010, 6:44 PM

Some hospitals hire non-nurse IBCLC's I think, but it is pretty rare and on a state by state basis. They are all allowed to hire us, but some just don't because we are not nurses, for example in Hawaii where I was trying to get a job in a hospital as an IBCLC and was turned down because I'm not a nurse.

Do you think that if the IBCLC credential becomes more diverse (including better practical and communication skills and yes also some more medical training) that more hospitals might consider hiring us?

I think it would help a lot if there was a license available for IBCLC's... but I may be asking for too much in this century : )

> >

> > Here's an idea to

> make it less burdensome for the student: the ones with a background in science

> have to take a customized counseling and practical course and the ones from

> the lay background have to take a customized course with the science- which

> could be fairly abbreviated but include some practical things about how MD

> practices and hospitals work, and of course, infection procedures. Maybe with

> a practical in hospital?

> > Both courses would need to be available by

> internet, with practicals arranged regionally.

> > Well, I haven't

> thought this through completely- probably has a lot of holes in it. We will

> lose some of the heart of the thing by not admitting lay people who bring a

> different viewpoint to it all, though.

> > , LLLL, IBCLC, and

> former RN

> >

> > Re: New IBLCE

> requirements

> >

> >

> >

> > I take your point, Ghislaine.

> I wonder, though, about the wisdom of changing the requirements without a

> curriculum in place. I wonder about the international exam hopefuls, and their

> ability to find an appropriate course to study. It still seems to me that

> these new requirements will make many LLL Leaders or others coming from a peer

> support background think twice about becoming an IBCLC. I also think there is

> some learning curve whenever we start a new job, but perhaps there is some

> other way to make the curve less steep. Also, in private practice, perhaps an

> LC doesn't need to know quite as much about the ins and outs of how a hospital

> works as a hospital-based LC. I don't have the answers, but I was surprised

> when I heard about the new requirements and wondered why they were put in

> place.

> >

> > Kimberley

> >

> > Kimberley MacKenzie, LLLC

> Leader, IBCLC

> >

>

[Guest guest]

Of course I can't speak to precisely 'why' the changes we are discussing have

been implemented as I wasn't involved. But I can speculate. I come from a

teaching background in vocational/technical career training. Part of the

development of 'career training' involves the dissection of the various job

tasks and duties performed within a specific discipline.

Once you have identified the various job tasks and duties the outcomes are taken

into consideration as the required education to achieve the job tasks is

identified. What this means is let's say entry level mechanics are expected to

have an elementary understanding of the basic components of an automobile

engine. In order to create that outcome, as a teacher we must facilitate

curriculum that provides the learner with the foundational education related to

the basic components of an automobile engine, or require that type of training

as a 'prerequisite' before progressing along the career training at some point,

or require the completion of a course that would achieve the desired outcomes

before entering the career training program.

When I look at the existing requirements (and keep in mind my perspective is

certainly flavored by my related education and experiences in teaching career

training), it is glaringly obvious to me that the IBLCE lists competencies of

entry level IBCLC's that exceed the education they are currently requiring the

exam applicant to obtain.

>

> I agree with Kimberley and Dee here. The requirements will prevent many LLL

Leaders and other bf counselors from pursuing the IBCLC credential. The best

IBCLCs I know are (or were) LLL Leaders!

>

> It is also another step toward medicalizing breastfeeding, which I think does

a disservice to moms and babies.

>

> I'm disappointed, to say the least. I *would* like to see additional

'advanced' credentials or sub-specialities for IBCLCs.

>

> Another option would be to make the test harder. Or add clinical

demonstration as part of the exam. That could help to test knowledge AND

counseling skills. I do understand how challenging and expensive that would be

for IBLCE to implement at this time.

>

> I have not taken many of the courses that will be required in 2012 and I

scored in the 90s last year.

>

> I would be interested to know how they decided to make these changes. Do they

look at data correlating education with exam performance? Are those with less

education performing poorly? I was equally curious a few years ago when they

made the education 'recommended' rather than 'required'.

>

> I am also curious to know what our colleagues around the world think of these

changes. I imagine in some areas, the education requirements (or lack of access

to this type of education) will prohibit many potential IBCLCs from achieving

the credential, and I think that is a shame.

>

> Healy

> Seattle, WA

>

[Guest guest]

It's been very interesting to read everyone's comments on this thread. A few

things jump out at me:

One is an assumption that IBCLC's that derive from a LLL or peer counselor

background will some how have their counseling skills, abilities, and empathy

diluted or diminished, if it is required that they take 2 science based courses

(biology and A & P), and 6 classes in social sciences (human development,

nutrition, psychology/counseling, research methodology and sociology). Nobody

thinks that taking these courses might actually build upon the existing

foundation these professionals possess and enhance their knowledge, skills, and

abilities?

The second, and probably most striking thing that jumps out at me is the virtual

absence of discussion regarding how these requirements may enhance or detract

the degree of competence with which we serve families. The dialogue has

overwhelmingly centered around how the requirements will effect the ability of

persons with or without a specific type of training/education, to obtain

certification and employment. Very little has been mentioned regarding what

education, training, and experience is most optimally suited to provide

competent support for mothers and babies.

The study of body systems (A & P), and cells, genes and organisms (biology) does

not imply every applicant required to take these courses will now be possessed

with obsessions related to 'pathology' or 'abnormal'. There are barriers to

accessing education, but would we ever minimize the level of education that is

necessary to become a physician because the candidate resides in an area where

it is difficult to access the necessary resources? That's not the solution, now

we are tasked with evaluating the obstacles this may create for some

populations, and identifying innovative ways to eliminate barriers.

I do appreciate the dialogue and I certainly have considerable regard for

everyone involved, despite the absence of like minded opinions about this topic

[Guest guest]

i think we're more alike than not.--at least I for one can see each person's point. The underlying problem, I think, is that what we do is messy. It's not neatly defined and because we work with at least 2 individuals who have never been written about in any book we are always going in "blind." Yes, we have our knowledge base and experience base, but we've NEVER seen this particular situation before. Add to this the fact that the health care profession as a whole is just beginning to figure out who we are and how we can participate--well, you see what I mean. It's no wonder we have so many different viewpoints.My experience with IBLCE/ILCA is they really don't seem to get what we do in private practice. They have a hospital-based perspective. I got that impression when I was talking to them about the

requirements for mentoring. So I think there is some bias. And the bias is understandable since the vast majority of LC's work in hospitals and are RN's. I am definitely for more education and higher standards, but I get a little defensive when I feel that my particular path (6 years and 2500 hours!) to IBCLC may be considered to be inadequate. I know no one is saying that, but I understand the concern that some very good candidates may be discouraged.I'm so impressed by the thoughtfulness and collective brain-power of this group! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- Subject: Re: New IBLCE requirementsTo: Date: Monday, May 17, 2010, 9:12 PM

It's been very interesting to read everyone's comments on this thread. A few things jump out at me:

One is an assumption that IBCLC's that derive from a LLL or peer counselor background will some how have their counseling skills, abilities, and empathy diluted or diminished, if it is required that they take 2 science based courses (biology and A & P), and 6 classes in social sciences (human development, nutrition, psychology/counseling, research methodology and sociology). Nobody thinks that taking these courses might actually build upon the existing foundation these professionals possess and enhance their knowledge, skills, and abilities?

The second, and probably most striking thing that jumps out at me is the virtual absence of discussion regarding how these requirements may enhance or detract the degree of competence with which we serve families. The dialogue has overwhelmingly centered around how the requirements will effect the ability of persons with or without a specific type of training/education, to obtain certification and employment. Very little has been mentioned regarding what education, training, and experience is most optimally suited to provide competent support for mothers and babies.

The study of body systems (A & P), and cells, genes and organisms (biology) does not imply every applicant required to take these courses will now be possessed with obsessions related to 'pathology' or 'abnormal'. There are barriers to accessing education, but would we ever minimize the level of education that is necessary to become a physician because the candidate resides in an area where it is difficult to access the necessary resources? That's not the solution, now we are tasked with evaluating the obstacles this may create for some populations, and identifying innovative ways to eliminate barriers.

I do appreciate the dialogue and I certainly have considerable regard for everyone involved, despite the absence of like minded opinions about this topic

[Guest guest]

I think there will be so few IBCLCs left who are not nurses after this that it

will be a moot point.

Tow, IBCLC, CT, USA

> > >

> > > Here's an idea to

> > make it less burdensome for the student: the ones with a background in

science

> > have to take a customized counseling and practical course and the ones

from

> > the lay background have to take a customized course with the science-

which

> > could be fairly abbreviated but include some practical things about how MD

> > practices and hospitals work, and of course, infection procedures. Maybe

with

> > a practical in hospital?

> > > Both courses would need to be available by

> > internet, with practicals arranged regionally.

> > > Well, I haven't

> > thought this through completely- probably has a lot of holes in it. We

will

> > lose some of the heart of the thing by not admitting lay people who bring

a

> > different viewpoint to it all, though.

> > > , LLLL, IBCLC, and

> > former RN

> > >

> > > Re: New IBLCE

> > requirements

> > >

> > >

> > >

> > > I take your point, Ghislaine.

> > I wonder, though, about the wisdom of changing the requirements without a

> > curriculum in place. I wonder about the international exam hopefuls, and

their

> > ability to find an appropriate course to study. It still seems to me that

> > these new requirements will make many LLL Leaders or others coming from a

peer

> > support background think twice about becoming an IBCLC. I also think there

is

> > some learning curve whenever we start a new job, but perhaps there is some

> > other way to make the curve less steep. Also, in private practice, perhaps

an

> > LC doesn't need to know quite as much about the ins and outs of how a

hospital

> > works as a hospital-based LC. I don't have the answers, but I was

surprised

> > when I heard about the new requirements and wondered why they were put in

> > place.

> > >

> > > Kimberley

> > >

> > > Kimberley MacKenzie, LLLC

> > Leader, IBCLC

> > >

> >

>

[Guest guest]

A lot of what you're saying makes sense. But there's one thing I am concerned

about. The reason I have this concern is that before I was an IBCLC, I was

'handled' by some hospital IBCLC's with my baby. It was not a pleasant

experience.

If LLL leaders and the like are required to take further education, (which I

think may be quite good for the IBCLC profession at large), I also think that

Doctors, Nurses and anyone who is not a LLL leader, or Breastfeeding/peer

counsellor be required to gain at least 500 hours of their lactation experience

under the supervision of a LLL leader.

How about that?

Hopefully this would discourage hospital personal from pursuing the profession

who were not totally committed to supporting women, at the same time as

improving their skills in really helping women at the level those women need,

AND making the IBCLC profession a fair playing ground for all candidates who

apply, doctor, nurse, lll leader or doula.

It's true that midwives used to protect birth, until it was medicalized and

criminalized for all who were not Doctors. Slowly, SLOWLY we midwives have come

(and are still coming) back to protecting birth legally because women wanted

midwives to be with them and remind them of their strength, not doctors to save

them from their inadequate female bodies.

Remeika, CPM, CaLM, IBCLC

Home-birth Midwife and Lactation Consultant

>

> I think a lot of interesting and thought provoking comments have been made

> over the past days concerning the new requirements, and as we continue to

> debate the changes,with all due respect, I would like to add a few points,

> too.

>

> We are a young profession, trying to legitimize our role in the medical

> community, as well as with the public. We all bemoan the wide range of

> skills and knowledge among entry level IBCLCs. This diversity of abilities

> and skills extends to countries beyond North America. Standardizing

> education is one way not only to address this inconsistency, but also

> increase our credibility among other medical professionals and the public

> (remember how we all complain about the CLC, LC, CBE, CLE, etc. issues and

> lack of standards?). More education strengthens the credential, not weakens

> it. I don't understand how anyone can argue that no education in topic A is

> better than some education in topic A. As a former LLLL, and an

> international relations/French major in college, I feel that both of these

> educational experiences contributed to my lactation professional

> development--by helping me learn how to think critically, appreciate

> learning, understand other's views, and recognize when I needed more

> education.

>

> Education has to be verifiable. Like it or not, the best universal way of

> guaranteeing that, across countries and cultures, is at the university

> level. While you individually may not feel that you need to know about

> hospital procedures because you are in private practice, as a profession, we

> need to look beyond our individual needs and focus on growing the profession

> appropriately and credibly. Other allied hcp's don't have different sets of

> requirements for those in private practice vs. those in institutional

> settings, so I think it would serve us well to follow the same model.

> Setting up multiple modalities for the " haves vs the have nots " of previous

> college level science education is not only unwieldy, but also financially

> impossible. Other health care professions don't do it, and never have.

> Would you rather see physician who has a 'module' in an important aspect

> within the scope of his practice or one who has a course in it?

>

> I think one of the problems is that we've put the cart before the horse

> here. By pursuing the establishment of the credential on an international

> level, by not more closely following the path of development established by

> other allied hcp's, we have gotten ourselves into this pickle. But we're

> here, so we have to keep moving forward. Beefing up educational

> requirements is a stepping stone to establishing a college level degree in

> lactation consultation. But realistically, while ILCA is working toward

> developing that suggested curriculum, I'd put my money on it's being years

> if not decades away from universal application at the US university

> level. Colleges are in business to make money, and it's going to take some

> hard selling convince them that a degree in lactation is going to do it for

> them. We shouldn't wait around for that to happen at the expense of

> strengthening IBCLCs academic credentials. If anything, strengthening

> academic requirements will enhance the argument for making lactation a

> college level degree program.

>

> Personally, I find the argument that the new requirements will shut out LLLL

> or other peer counselors to be weak at best. People who really want to

> become an IBCLC will find a way to do it, one way or another, whether it

> means delaying aspriations for a few years until kids are older, money is

> saved for courses, scholarships can be found, or any other preceived

> roadblock can be overcome. People who want to go into any profession, or to

> go to college badly enough find a way to do it. People who don't, don't.

> Just because education is a " huge hassle " it should not be an obstacle to

> achieving a professional goal. Nor should some individuals' perceived

> inability to surmount those challenges prevent the rest of the profession

> from advancing.

>

> Decisions to amend or expand the eligibility criteria do not happen in a

> vacuum, at the whim of those who woulld like to 'medicalize'

> breastfeeding. Such issues as test validity, indices of professional

> competence, standards of performance based on job descriptions, job skills

> inventories, requirements for other allied health care professions, and

> statistical research on pass rates as they correlate to years of university

> education, among other things, all play a role in the discussion of

> prerequisite changes. Yes, you can interpret these changes as the

> " medicalization of breastfeeding " . This may seem callous, but you can't

> have it both ways. You either want to be respected as a legitimate,

> credential, licensed (could, perhaps, education play a role in this

> discussion?) professional or you don't. Often,fair or not, the reality is

> that you can either be the " breast lady " or the respected member of the

> health care team, whether you serve a mother-baby dyad in the hospital or on

> an outpatient basis. Unfortunately, for some, one of the ways to raise the

> standards and legitimze our contribution is through education; I don't think

> we can change that, and I'm not sure that fighting it would do us any good.

>

> Just for the record, yes, I do think that the profession will take a hit if

> LLLLs and other peer counselors perceive themselves to be 'shut out' by the

> new requirements and fail to pursue certification because of it. I do think

> the profession suffers to some degree by the disproportionate number of RNs

> whose practical breastfeeding knowledge and experience is largely, if not

> exclusively limited to the birth-3 days cohort. I think that many RNs are

> hurt by time and other constraints and responsibilities that limit them from

> learning as much as they can/should or from being able to use or recommend

> techniques and treatments that IBCLCs in private practice do. I do think

> that spending time in the peer counseling ranks builds exceptional

> counseling and interpersonal skills. But I also think that just like among

> physicians, there are those who have good bedside manner and those who

> don't, and RN status doesn't define which IBCLC will be a good

> counselor/listener and which won't. Being a peer counselor is not the only

> measure of defining a good counselor from a bad one; nor is it the only way

> to achieve these skills.

>

> The new requirements should be a wake up call for those of us who cannot

> steadfastly say we have qualifications in these areas of professional

> expertise, as defined by those who are responsible for defining them--the

> certifying organization. I for one know that I need to go back to school and

> beef up my background knowledge and am grateful to have that pointed out to

> me, as difficult as it is to swallow. Our recertification doesn't directly

> depend on it, and even if one's certification lapses,these new requirements

> still don't (largely) apply. (You can sit the exam if your certificaiton

> lapses by taking a number of CERPS and nothing else.). But our professional

> credibility and providing a high standard of care does. I think it's

> important to take a step back and reassess why we feel the way we do about

> these new requirements and to see if we measure up.

>

> Someone said that the profession was built on the tradition of

> mother-to-mother support, and that we were 'told' there would always be a

> place for the peer counselor pathway. There may be one or two of this

> profession's founding mothers rolling over in their graves, but those things

> have not changed. I vote for embracing the change as a way to strengthen

> and grow our profession.

>

> Barbara Ash, MA, IBCLC, PCD (DONA)

>

[Guest guest]

oh, I like that getting supervised hours from LLL! wickedly clever idea, ! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- Subject: Re: New IBLCE

requirementsTo: Date: Wednesday, May 19, 2010, 3:46 PM

A lot of what you're saying makes sense. But there's one thing I am concerned about. The reason I have this concern is that before I was an IBCLC, I was 'handled' by some hospital IBCLC's with my baby. It was not a pleasant experience.

If LLL leaders and the like are required to take further education, (which I think may be quite good for the IBCLC profession at large), I also think that Doctors, Nurses and anyone who is not a LLL leader, or Breastfeeding/peer counsellor be required to gain at least 500 hours of their lactation experience under the supervision of a LLL leader.

How about that?

Hopefully this would discourage hospital personal from pursuing the profession who were not totally committed to supporting women, at the same time as improving their skills in really helping women at the level those women need, AND making the IBCLC profession a fair playing ground for all candidates who apply, doctor, nurse, lll leader or doula.

It's true that midwives used to protect birth, until it was medicalized and criminalized for all who were not Doctors. Slowly, SLOWLY we midwives have come (and are still coming) back to protecting birth legally because women wanted midwives to be with them and remind them of their strength, not doctors to save them from their inadequate female bodies.

Remeika, CPM, CaLM, IBCLC

Home-birth Midwife and Lactation Consultant

>

> I think a lot of interesting and thought provoking comments have been made

> over the past days concerning the new requirements, and as we continue to

> debate the changes,with all due respect, I would like to add a few points,

> too.

>

> We are a young profession, trying to legitimize our role in the medical

> community, as well as with the public. We all bemoan the wide range of

> skills and knowledge among entry level IBCLCs. This diversity of abilities

> and skills extends to countries beyond North America. Standardizing

> education is one way not only to address this inconsistency, but also

> increase our credibility among other medical professionals and the public

> (remember how we all complain about the CLC, LC, CBE, CLE, etc. issues and

> lack of standards?). More education strengthens the credential, not weakens

> it. I don't understand how anyone can argue that no education in topic A is

> better than some education in topic A. As a former LLLL, and an

> international relations/French major in college, I feel that both of these

> educational experiences contributed to my lactation professional

> development--by helping me learn how to think critically, appreciate

> learning, understand other's views, and recognize when I needed more

> education.

>

> Education has to be verifiable. Like it or not, the best universal way of

> guaranteeing that, across countries and cultures, is at the university

> level. While you individually may not feel that you need to know about

> hospital procedures because you are in private practice, as a profession, we

> need to look beyond our individual needs and focus on growing the profession

> appropriately and credibly. Other allied hcp's don't have different sets of

> requirements for those in private practice vs. those in institutional

> settings, so I think it would serve us well to follow the same model.

> Setting up multiple modalities for the "haves vs the have nots" of previous

> college level science education is not only unwieldy, but also financially

> impossible. Other health care professions don't do it, and never have.

> Would you rather see physician who has a 'module' in an important aspect

> within the scope of his practice or one who has a course in it?

>

> I think one of the problems is that we've put the cart before the horse

> here. By pursuing the establishment of the credential on an international

> level, by not more closely following the path of development established by

> other allied hcp's, we have gotten ourselves into this pickle. But we're

> here, so we have to keep moving forward. Beefing up educational

> requirements is a stepping stone to establishing a college level degree in

> lactation consultation. But realistically, while ILCA is working toward

> developing that suggested curriculum, I'd put my money on it's being years

> if not decades away from universal application at the US university

> level. Colleges are in business to make money, and it's going to take some

> hard selling convince them that a degree in lactation is going to do it for

> them. We shouldn't wait around for that to happen at the expense of

> strengthening IBCLCs academic credentials. If anything, strengthening

> academic requirements will enhance the argument for making lactation a

> college level degree program.

>

> Personally, I find the argument that the new requirements will shut out LLLL

> or other peer counselors to be weak at best. People who really want to

> become an IBCLC will find a way to do it, one way or another, whether it

> means delaying aspriations for a few years until kids are older, money is

> saved for courses, scholarships can be found, or any other preceived

> roadblock can be overcome. People who want to go into any profession, or to

> go to college badly enough find a way to do it. People who don't, don't.

> Just because education is a "huge hassle" it should not be an obstacle to

> achieving a professional goal. Nor should some individuals' perceived

> inability to surmount those challenges prevent the rest of the profession

> from advancing.

>

> Decisions to amend or expand the eligibility criteria do not happen in a

> vacuum, at the whim of those who woulld like to 'medicalize'

> breastfeeding. Such issues as test validity, indices of professional

> competence, standards of performance based on job descriptions, job skills

> inventories, requirements for other allied health care professions, and

> statistical research on pass rates as they correlate to years of university

> education, among other things, all play a role in the discussion of

> prerequisite changes. Yes, you can interpret these changes as the

> "medicalization of breastfeeding". This may seem callous, but you can't

> have it both ways. You either want to be respected as a legitimate,

> credential, licensed (could, perhaps, education play a role in this

> discussion?) professional or you don't. Often,fair or not, the reality is

> that you can either be the "breast lady" or the respected member of the

> health care team, whether you serve a mother-baby dyad in the hospital or on

> an outpatient basis. Unfortunately, for some, one of the ways to raise the

> standards and legitimze our contribution is through education; I don't think

> we can change that, and I'm not sure that fighting it would do us any good.

>

> Just for the record, yes, I do think that the profession will take a hit if

> LLLLs and other peer counselors perceive themselves to be 'shut out' by the

> new requirements and fail to pursue certification because of it. I do think

> the profession suffers to some degree by the disproportionate number of RNs

> whose practical breastfeeding knowledge and experience is largely, if not

> exclusively limited to the birth-3 days cohort. I think that many RNs are

> hurt by time and other constraints and responsibilities that limit them from

> learning as much as they can/should or from being able to use or recommend

> techniques and treatments that IBCLCs in private practice do. I do think

> that spending time in the peer counseling ranks builds exceptional

> counseling and interpersonal skills. But I also think that just like among

> physicians, there are those who have good bedside manner and those who

> don't, and RN status doesn't define which IBCLC will be a good

> counselor/listener and which won't. Being a peer counselor is not the only

> measure of defining a good counselor from a bad one; nor is it the only way

> to achieve these skills.

>

> The new requirements should be a wake up call for those of us who cannot

> steadfastly say we have qualifications in these areas of professional

> expertise, as defined by those who are responsible for defining them--the

> certifying organization. I for one know that I need to go back to school and

> beef up my background knowledge and am grateful to have that pointed out to

> me, as difficult as it is to swallow. Our recertification doesn't directly

> depend on it, and even if one's certification lapses,these new requirements

> still don't (largely) apply. (You can sit the exam if your certificaiton

> lapses by taking a number of CERPS and nothing else.). But our professional

> credibility and providing a high standard of care does. I think it's

> important to take a step back and reassess why we feel the way we do about

> these new requirements and to see if we measure up.

>

> Someone said that the profession was built on the tradition of

> mother-to-mother support, and that we were 'told' there would always be a

> place for the peer counselor pathway. There may be one or two of this

> profession's founding mothers rolling over in their graves, but those things

> have not changed. I vote for embracing the change as a way to strengthen

> and grow our profession.

>

> Barbara Ash, MA, IBCLC, PCD (DONA)

>

[Guest guest]

I couldnt agree more. I sat the exam with a broad range of people,

some were recertifying, others were breastfeeding counsellors sitting

the exam, others were health professionals who had sought a wide range

of lactation experience, and others were health professionals who had

done the bare minimum and had used their hospital time as their

lactation hours. No prizes for guessing which group had the most

trouble with the exam. Yes, the health professionals who had done the

bare minimum. Those who had done extra study and had sought out a

wide range of lactation experience did well, the recertifiers, mostly

did well, because the ones who find it all too hard, don't seem to

come back, and the counsellors, well we had a lot of lactation

experience, and while we found some of the medical questions tricky,

or even impossible, we still found the exam fairly easy and scored in

the 80s. Why is this, basically because it is a lactation specific

qualification, so you need a really good strong understanding of

lactation to pass it. Yes the medical stuff is important, and yes I

do need to revise it, but lactation is our foundation, and hospital

midwives only see the early days of lactation. In fact as a trained

breastfeeding counsellor, I needed to look up newborn stuff, because I

don't deal with that so much.

So I do think that beefing up the qualification is a good thing,

however, they really need to be a lot more specific about lactation

hours. Time working as a mid on the wards is just not good enough,

you don't get a wide enough range, and with mums being sent home after

24 hours, you really don't get to see much at all.

Doncon

Breastfeeding Counsellor, IBCLC, Australia

(read my expressing story here:

http://www.lrc.asn.au/forum/viewtopic.php?t=41257

and my weaning diary here http://www.lrc.asn.au/forum/viewtopic.php?t=40015)

>

> If LLL leaders and the like are required to take further education,

> (which I think may be quite good for the IBCLC profession at large),

> I also think that Doctors, Nurses and anyone who is not a LLL

> leader, or Breastfeeding/peer counsellor be required to gain at

> least 500 hours of their lactation experience under the supervision

> of a LLL leader.

[Guest guest]

While I also appreciate the dialogue, I also believe that much of the

discussion centering on barriers is not focused on the real source of

the problem. The real source of the barriers towards a more

comprehensive education are economic. Many of these barriers are

specific to the United States because we do not have a system for

publically-funded higher education, just as we do not have a system

for publically-funded health care for any but the elderly. If anyone

who was interested and qualified were able to pursue a course of

higher education without the tremendous economic barriers that face

some populations and if those who sought lactation services were able

to receive those services without worrying that their health

insurance company would deny coverage, I doubt that we would be

pitting one skill against another. It reminds me of a dispute that

erupted on the listserve at my son's school where parents were

complaining about lack of physical education and then a group of

parents starting complaining that art was underfunded and more

important than physical education. Both are important. I do think

we would benefit from more thorough coursework and I absolutely agree

that in the United States we have created substantial barriers for

many people to be able to meet these higher requirements. I actually

do not believe it will be as hard to achieve these standards in other

countries with better publically-funded education.

When I deliberately ensured that I would be reorganized out of my

previous position in international nutrition, I was able to get both

unemployment insurance and continued unemployment benefits because I

was " retraining " myself for a new job. Such provisions are even less

likely to be available at this point in time.

Best, E. Burger, MHS, PhD, IBCLC

[Guest guest]

I completely agree that cost can be an obstacle. Interestingly enough, in our

limited conversation amongst members of this group, lack of access to

educational resources was not referred to nearly as often as other justification

for not requiring the coursework. The resounding theme I interpreted from a

majority of the respondents who are not in support of the new additional

requirements is not only are the science courses unnecessary, they 'medicalize'

breastfeeding and I believe some commenters implied that they would

(paraphrase?) harm the profession. I haven't heard much response to the

additional 6 required social science courses.

Speaking for myself here this completely confuses me. Even professions that are

classically known to be women centered and holistic require the study of basic

A & P, and biology. Midwifery, chiropractic, naturopathic care. The new IBLCE

requirements are not intensely focused on science however, a fundamental A & P

course (they are not even requiring a lab, which would be required for a

prospective medical professional, and 2-4 quarters, not just one class), and

biology. As a teacher I am always alarmed when I hear comments related to

'already knowing' material when people have not taken the class/related class,

or diminishing the value of particular coursework. I will humbly confess that I

have had moments of that myself, however for me I learned pretty quick that when

I am patient, in the end, the purpose often becomes very evident and I have come

to regret the resistance or skepticism with which I approached the material or

requirement.

Professionals working within intense human systems are often required to have

taken biology and A & P, math etc. although their discipline may be considered a

social science (counselors, psychologists, psychotherapists, social workers,

human services professionals). Decades of professional evaluation of the

necessary skills to perform the job tasks demonstrates the improved ability of

the worker to recognize 'normal',extraordinary, and abnormal, in order to

facilitate the most appropriate referrals and interventions,when workers have

been exposed to basic life sciences.

And I give the La Leche League Leaders and Peer Counselors in my life way more

credit than to imply (if they haven't already) taking an A & P class and studying

biology would have a negative influence on their ability to retain their

empathy, compassion, and superb counseling skills. As if requiring a RN or any

other medical professional to study active listening and counseling techniques

would diminish their understanding of A & P and biology?

>

> While I also appreciate the dialogue, I also believe that much of the

> discussion centering on barriers is not focused on the real source of

> the problem. The real source of the barriers towards a more

> comprehensive education are economic. Many of these barriers are

> specific to the United States because we do not have a system for

> publically-funded higher education, just as we do not have a system

> for publically-funded health care for any but the elderly. If anyone

> who was interested and qualified were able to pursue a course of

> higher education without the tremendous economic barriers that face

> some populations and if those who sought lactation services were able

> to receive those services without worrying that their health

> insurance company would deny coverage, I doubt that we would be

> pitting one skill against another.

[Guest guest]

Which insurance companies have you found that have actually reimbursed your clients?InaBrooklyn NY--Ina Bransome, IBCLC, PCD, CD (DONA)Int'l Board Certified Lactation ConsultantMentoring for Parents of Newbornshttp://www.clearbirth.comalas, , perhaps we are asking too much.  (sigh)  I think things may be changing though.  My services are now being covered by a couple of major ins. companies.  I'm hoping it's a trend!  I did work in a hospital here for a couple of years,(they just called me when a patient needed help so I wasn't doing rounds per se)  but I was hired by a very think-outside-the-box nurse manager who really didn't care about upper management.  It worked well for everyone till a new nurse manager took over and "cleaned house."  it was nice while it lasted. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula  www.second9months.comBreastfeeding Between the Lines:  http://second9months.wordpress.com/

[Guest guest]

most recently regence and blue cross. I believe cigna and aetna have also reimbursed in the past. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- Subject: Re: Re: New

IBLCE requirementsTo: Date: Friday, May 21, 2010, 3:55 PM

Which insurance companies have you found that have actually reimbursed your clients?InaBrooklyn NY--Ina Bransome, IBCLC, PCD, CD (DONA)Int'l Board Certified Lactation ConsultantMentoring for Parents of Newbornshttp://www.clearbir th.comalas, , perhaps we are asking too much. (sigh) I think things may be changing though. My services are now being covered by a couple of major ins. companies. I'm hoping it's a trend! I did work in a hospital here for a couple of years,(they just called me when a patient needed help so I wasn't doing rounds per se) but I was hired

by a very think-outside- the-box nurse manager who really didn't care about upper management. It worked well for everyone till a new nurse manager took over and "cleaned house." it was nice while it lasted. Beebe, M.Ed., IBCLC Lactation Consultant/Postpart um Doula www.second9months. comBreastfeeding Between the Lines: http://second9month s.wordpress.

com/