Thursday, March 29, 2012

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To IBCLC or to not IBCLC? That is the question

I've been thinking a lot about becoming a Certified Lactation Consultant through the International Board of Certified Lactation Examiners versus working towards the goal of Certified Lactation Counselor. I got into a conversation with a friend of mine who is the one who really started me thinking about it. Actually, we talked plenty about the IBCLC program, school and a few other things on the topic, and when I talked to her about the reasons behind why I'm here interested in human lactation, and what my plans are she started talking to me about other avenues, saying IBCLC may not be necessary. This conversation really left me thinking. So much so that I've been going over this in my head, and really started to do a comparison of the two.

Becoming an IBCLC, means one has an extensive understanding of human lactation. It is the highest credential available for health care professionals who specialize in the area, and is seen as having the most thorough knowledge -- an expert. It's like having a PhD in the lactation world. Sort of. There are many requirements on the path to becoming certified, including general education courses from an accredited institution, accumulating clinical hours (working or volunteering specifically towards lactation in a supervised environment), and taking other lactation-specific education classes. Once completed, and after passing an exam that is administered worldwide only one day per year by the IBCLE, a Lactation Consultant can work in various settings, including Dr.s offices and hospitals, and earn quite competitive salaries. It even allows consultants to have their own practice and bill insurance companies for services. Some of the benefits of a Lactation Consultant are below, but a much more comprehensive list can be viewed from the Norma Ritter, IBCLC website:

  • Adjusting to life with a newborn
  • Adoptive nursing
  • Anesthesia
  • Baby wearing
  • Biting
  • Bottles 
  • Breast refusal
  • Choosing a pump
  • Cleft lip/cleft palate 
  • Colic
  • Cultural issues
  • Dealing with criticism
  • Dental and oral health
  • Disabled or handicapped mothers or babies
There is no denying the role of IBCLCs; that they have made a tremendous impact on mother and baby, and can be thanked for countless successful breastfeeding outcomes and other areas where they have served, and I definitely admire their work! However, when I visited a site dedicated to those pursuing a Certified Lactation Counselor program, here are some of the things I read:

Certified Lactation Counselors (CLCs) are individuals who have successfully completed the Healthy Children Project’s Certified Lactation Counselor Training Program, [or another program through a different organization] an Accredited ANCC Nursing Skills Competency Program™∗ and are also certified by the Academy of Lactation Policy and Practice (ALPP).

Here are a few key points that stood out. CLCs:
  • Construct and maintain conditions that predispose mothers and babies to an uncomplicated breastfeeding experience through counseling, education and support.  
  • Develop a care plan specific to the needs identified through assessment
    and counseling  
  • Ability to use appropriate, effective and sensitive communication skills. 
  • Ability to apply the concept of an individualized approach to counseling and management of breastfeeding. There is more information on CLCs here.

When I read about and thought on this, becoming a Certified Lactation Counselor appears it would provide more of a qualitative approach to breastfeeding, and seems to touch the areas that resonate with what I want to do. I like looking at those things at the center of lower breastfeeding rates and presenting information to people, and hope to continue to do this with individuals and in large and small groups, through awareness and advocacy. I have no desire to work in a hospital or any other type of clinical setting. And as I've given more and more thought on Public Health and Anthropology, this is something that just may work out even better for my overall endeavor; and I especially like the one-size does not fit all approach.

The coursework and hours completed for a Certified Lactation Counselor are requirements for IBCLC, so if I happen to change my mind down the road and if it's within the five year time frame required by the Board, I can just continue towards that 'Lactation PhD'. So not only is this a great start, it will allow me to nicely gauge my path.

In my breastfeeding advocacy, I hope to continue looking at more than just the clinical or mechanical aspects of breastfeeding -- attaching an infant to it's mother's breast; there's just so much more to the story. And it takes so much more to combat disparities. I want to explore the theoretical -- the cultural, social, political, historical, interpersonal and many other areas that are always at the forefront, that hinders greater success and continue challenging these. But I certainly don't need those credentials behind my name in order to promote the ritual and make a difference, or to help out with matters in those other categories -- cultural criticism, adjusting to life with a newborn, colic, babywearing and several others. And even though receiving certification through the International Board of Certified Lactation Examiners would give me 'status' and most likely provide a salary I definitely could never expect as a professor of anthropology, I can gain invaluable information outside of this mainstream trajectory, and increase my knowledge and understanding of the area through the actual lived experiences of people around me. I just may like what CLC has to offer instead -- actually talking to someone about breastfeeding -- learning their ways and thoughts; You know, getting to know somebody, and encouraging them along the way. 

Update: I talked to someone about the programs for CLC, and was told that instead of Lactation Counselor, CLE (Certified Lactation Educator) is a very viable option for many in the area, and "qualifies persons to teach, support, and educate the public on breastfeeding and related issues." I'll do my research on this one as well, and will absolutely keep you posted!