By Liz Brooks, JD, IBCLC, ILCA President
“The IBCLC is the globally recognized professional authority in lactation.”
There it is … the Vision Statement for the International Lactation Consultant Association (ILCA). As the President of ILCA and an IBCLC in private practice, I am proud of this important strategic objective by my professional association.
So imagine my consternation to read an e-mail from one of ILCA’s members, who expressed concern about the Joint Stakeholder Letter recently sent worldwide as part of a multi-organizational effort to promote the International Board Certified Lactation Consultant (IBCLC) credential and profession. Her primary concern: a message that IBCLCs are trying to keep other breastfeeding helpers from providing care to lactating women.
Oh, dear, I thought. That isn’t ILCA’s goal at all! How could our vision be misconstrued? Yet, it is not the first time I have heard about confusion over ILCA’s efforts to market the IBCLC credential.
So let me take a stab at explaining the motivation behind ILCA’s Vision and Mission, and the sending of the “Joint Stakeholder Letter” by ILCA (and co-signed by the International Board of Lactation Consultant Examiers, IBLCE, our certifying arm, and the Lactation Education Accreditation and Approval Review Committee, LEAARC, the organization promoting excellence in lactation education and curricula).
ILCA, IBLCE and LEAARC have never espoused the notion that only IBCLCs are able to provide support to breastfeeding families. Most mothers in the world do not even need the special skill and expertise that an IBCLC can bring to bear! Indeed, in a perfect world, every woman giving birth would be surrounded by female relatives, friends and neighbors — all of whom had happily and successfully breastfed their own children. Mother-to-mother connections have been going on since the dawn of time, and the simple feat of “learning by watching” and “teaching by doing” is the quintessential practice of breastfeeding support.
We are fortunate that modern medicine has allowed families — who otherwise would not have conceived or been able to fully lactate — to be able to bear children, and boost milk supply. Premature and sick babies are going home from the neonatal intensive care unit, to live full and fruitful lives. On the flip side, in our modern day world, women of child-bearing age (who comprise the greatest segment of the working population) often are not able to be with their breastfeeding children around-the-clock.
Situations such as these create tremendous challenges for lactating women. The demand for a specialty in the allied health care field was borne precisely from the recognition (by La Leche League Leaders) that some breastfeeding mothers need more than the loving, compassionate support of friends, relatives, and mother-to-mother counselors. And they recognized that primary healthcare providers (such as pediatricians, midwives and gynecologists) were not getting training or clinical rotation in lactation support during their own education.
The IBCLC is the only international credential in breastfeeding and human lactation, awarded by an independently-accredited organization. Those with the IBCLC credential are members of the health care team, who can help (and advocate for) mothers and babies with those higher-order challenges. It is a stand-alone credential, and the requirements for it to be awarded are substantial.
Distinguishing the IBCLC from other kinds of breastfeeding support is necessary, because we also know that there is tremendous confusion (by mothers, hospital administrators, and public health regulators) about “Who Is Who” in the field of lactation support. I just typed “get help sore nipples” into Google, and got 1,070,000 results. Options included sites for nipple creams and products, anonymous chat rooms, websites by medical professionals, websites by mother-to-mother groups, makers of baby products, etc. Imagine being the tired, sore, weepy mother, typing that phrase into her laptop at 3AM. Which site should she visit? What do all those initials mean?
Thus, ILCA (IBLCE and LEAARC) identified the need for promotion of the IBCLC credential and profession. Not to the exclusion of other kinds of helpers … but as the well-understood, stand-alone allied healthcare professional credential that it is. No one group of breastfeeding helpers (doctors, midwives, IBCLCs, peer counselors, mother-to-mother counselors, those who’ve acquired specialized short-term educational training) can “corner the market” on helping mothers. That is impossible. Does anyone think breastfeeding mothers have too much help and support?
But a corollary concept is: Each kind of breastfeeding support should be well and honestly marketed to the public — to the mothers, employers, hospital administrators and public health decision-makers who seek varying levels of expertise.
Every mother, everywhere, deserves to know what went into the education and training of the person who stands before her, offering support for breastfeeding.
For ILCA, marketing the IBCLC credential and profession is the cornerstone of its Strategic Plan, Vision and Mission. For ILCA, marketing our position paper The Role and Impact of the IBCLC is one way of making sure that mothers who need an IBCLC will recognize when they are getting an IBCLC. The Joint Stakeholder Letter — first proposed in March 2011 — is an effort by all three organizations who work on behalf of our profession (ILCA, the professional association; IBLCE, the credentialing arm; LEAARC, the education component) to jointly and publicly promote the IBCLC credential.
Perhaps to close I will state the obvious: Breastfeeding is the mammalian norm and our biologic imperative … which means the true breastfeeding “authorities” are mothers and their children! When expert help and advocacy is called for … when breastfeeding issues are morphing from mothering questions into healthcare concerns … then “The IBCLC is the globally recognized professional authority in lactation.” To quote U. S. Surgeon General Regina Benjamin, “Everyone can help make breastfeeding easier,” to create a supportive environment for mothers, babies and families.
Well said Liz! While working as an IBCLC in the hospital setting I often came across hostility from midwives who felt we were intruding on their role. My response was to change my approach and insist that midwives accompany me during consults. That way the three of us (mother, midwife and IBCLC) could work together to identify the problem and devise a breastfeeding plan. This way the woman felt confident that the midwife could continue her care. It also was an opportunity for the midwife to upskill and improved communication between services to the point where instead of my job becoming less busy I found I was getting a lot more calls to ‘help work out a plan’. Much better!
Thank you, Liz!
As a recently retired Midwife from a hospital setting, and still an IBCLC in Private Practice, I endorse Cynthia’s stategy as above for practice in a midwifery setting. I also practiced that way which created an environment where midwives were keen and encouraged to upskill and actually came asking for my support and guidance in their practice.
Cynthia, you have created a fantastic model for shared care! It empowers the mother to participate in the development of her breastfeeding care plan — rather than simply be inflexibly “told” what to do by her healthcare providers — and it is what we are obligated to do as IBCLCs under the IBLCE Code of Professional Conduct and IBLCE Scope of Practice, and encouraged to do under the ILCA Standards of Practice. This greatly improves breastfeeding duration and exclusivity rate. As I like to say (with a hat-tip to Ursuline Singleton): IBCLCs empower mothers and save babies lives! Kudos to you for your clinical leadership!
Thank you Liz for your excellent commentary regarding the importance of the IBCLC credential. While it is widely recognized that there are many individuals and organizations willing and able to provide mothers with much needed support and encouragement, it is the IBCLC who has the unique skills and training to assist mothers and babies. I applaud ILCA’s mission and vision to promote the IBCLC credential.
Hey Janette — replies are leap-frogging comments here … I just saw yours. I am struck by how similar a practice-style you and Cynthia share. Whoo Hoo for that!
Well-written and says it all. Thanks Liz for taking the time to do this.