Gathering More Voices: The North and South America Panel at the 2014 Lactation Summit

The 2014 Lactation Summit was designed to listen and learn from the missing voices of the profession so that strategies for dismantling institutional oppression within the profession can be developed.

Much was learned from the 2014 Summit, but there is still listening to be done. Over the next few weeks, Lactation Matters will be breaking out the Summit findings from each community that spoke at the Summit. Our goal is two-fold: to shine a brighter light on the concerns raised in each session, and to solicit other voices who were not present at the Summit.

The 2014 Summit was the result of a year-long planning effort by a 22-member design team made up of diverse representatives from seven countries of the world. It was hosted jointly by International Board of Lactation Consultant Examiners® (IBLCE®), International Lactation Consultant Association® (ILCA®), and Lactation Education Accreditation and Approval Review Committee (LEAARC).

The design team recommended a structure to hear from 26 individuals representing the following categories:

• African Americans in the U.S.
• Hispanics in the U.S.
• Native Americans in the U.S.
• North and South America
• Asia Pacific
• Russia and Europe
• Communities that cross geographic and ethnic lines (males, lay breastfeeding support groups, those working in remote regions of the world, and the LGBTQI community)

While there are specific barriers unique to various racial, ethnic, geographic, and other groups, several general themes emerged that were common to many of the groups. These findings will help guide future discussions and action plans needed to dismantle institutional oppression.

The following is a summary of the assessments made by individuals representing the panel on North and South America. Read our other posts on the assessments made by individuals representing the panels on African Americans in the U.S., Native Americans in the U.S., and Hispanics in the U.S.. To access information on all of the panels presented, read a complete summary of the report here.

In future posts, we will be highlighting the assessments made by other communities in the order they were presented in the Summary Report.

We hope that, after reading, you will consider sharing your comments, ideas, and suggested solutions. Please click here to offer your input.

North and South America – Canada, Mexico, South America

Many real-world stories were shared, noting similar barriers already described. Additional issues of transportation, costs, and language were noted. It should be noted that the South American representative to the Summit was unfortunately unable to attend; input from South America will be critical moving forward.

Canada
In the world’s second largest country, travel and transportation costs, as well as distance and access to appropriate resources were identified as significant barriers to accessing the profession.

• Exam site assignments – do not always accommodate everyone. Some Canadians reported they had to take the take the exam in the United States, requiring passports and often significant travel expenses for airfare or mileage, hotel, meals, child care, and work replacement. Carpooling is often not possible as people are frequently assigned to take the exam at different sites in the U.S.

• Language barriers – pose hardships for many aspiring lactation consultants. This is further complicated when office staff for IBLCE do not speak French, making it more challenging to register for the exam.

• Racism – is a significant issue in Canada. For example, a painful history of killing First Nations children and outright abuse of aboriginals in Canada has resulted in continuing issues of discrimination and lack of access to appropriate health care among underrepresented groups. There is a great need for families to heal from intergenerational trauma.

• Cultural practices – of First Nations peoples are not recognized or valued by those from the dominant culture in Canada.

• Lack of IBCLC mentors – is a special concern within aboriginal communities. Because many aboriginals lack trust in the dominant culture, this is a significant need. Currently there is only one IBCLC in Canada from a First Nations tribe.

• Cost and lack of jobs – are significant challenges to motivating people to become IBCLCs in Canada.

Mexico
Despite the large population of Mexico (over 20 million in Mexico City alone) there are relatively few IBCLCs (only 20). There are 67 native languages spoken in Mexico, and there are wide variances in beliefs and practices surrounding breastfeeding, with significant issues impacting the lactation profession.

• The profession – is mostly unknown in the country. Lactation is not incorporated into medical training, and health providers are not knowledgeable about the profession.

• Lactation knowledge – is lacking. Many health workers believe they are already lactation experts. Unified evidence-based standards are not shared between health providers, resulting in inadequate lactation care. There are few Spanish language lactation courses and continuing education programs available to educate health professionals and aspiring IBCLC candidates and help them maintain the credential.

• Breastfeeding promotion – is challenging. Aggressive formula marketing practices have penetrated the indigenous communities in Mexico. Complementary feeding practices are not based on best practices in nutrition. While the Baby-Friendly Hospital Initiative (BFHI) is gaining momentum in the country, the public health department added 15 additional steps (for example, vaccinations) that make acquiring BFHI designation much more cumbersome and difficult to attain.

• Time constraints and high turnover – add to issues of lack of motivation and knowledge about the profession.

We welcome your comments, ideas, and suggested solutions. Please click here to offer your input.