Gathering More Voices: The Europe and Russia 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 Europe and Russia . 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., Hispanics in the U.S., North and South America, and Asia Pacific. 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.

Europe and Russia

The panel addressing issues in Europe and Russia noted that the three lactation organizations must be committed to truly being international. The processes to establish the profession and maintain it reflect the lens of the United States, and do not play out as intended in many countries of the world. Some of the significant issues addressed include:

• Few number of IBCLCs – creates challenges in Russia and Europe. In Russia, where there are 146 million people, there are only 10 IBCLCs. In Italy, where there are 60 million people, there are only 198 IBCLCs. In Latvia, a country of 2.1 million, there are 3 IBCLCs. In Ireland, with 4.6 million people, there are 167. When the numbers are small, it is harder to promote the profession and access appropriate education and clinical mentorship opportunities.

• The size of Russia – with 10 time zones within the borders of the country, access to education and clinical requirements is an uphill battle for aspiring IBCLCs.

• Few resources and training opportunities – are available in the Russian language. Currently only those who also speak English are able to take the exam as it is not yet translated into Russian or many other languages. Also, there are no educational materials in Russian; candidates must call sites with English-speaking operators to register for the exam.

• Only 13 of the 24 official languages approved by the European Union – are listed on the IBLCE website and only some information is translated; most key documents are not. ILCA has even fewer resources available in appropriate languages. English is spoken by around 50% of the peoples in Europe. Although many Europeans speak more than one language, English may not be one of them, or their understanding may be only at VERY basic levels. This is a significant issue since key documents and resources related to the exam are not available in the languages needed.

• Financial costs – in Russia, the dollar to ruble exchange is currently 1 to 50, where it was 1 to 33 before. That means the cost for preparing for and taking the IBCLC exam has become much less affordable. There are similar concerns in European countries, as well.

• Eligibility requirements – have affected many prospective IBCLCs. The required coursework is not readily available as individual courses, or affordable in Europe, and many online opportunities are available only in English.

• Access to education and training resources – in the appropriate language and at an affordable cost remains an ongoing challenge. This affects not only initial entrance to the profession, but also maintenance of the certification once it is attained. Many Europeans and Russians do not own credit cards, making it difficult to access online education such as webinars, and exchange rates can make overseas learning prohibitive, especially for Eastern Europeans. One 100-hour breastfeeding course has been developed in Russia for web-based learning to address these issues.

• Pathways – are limited in Europe. Pathway 1 is effectively limited to health care professionals due to unavailability of individual university courses and limited range of required lactation education courses. There are no Pathway 2 programs, and mentorship through Pathway 3 is limited due to lack of mentors. This effectively blocks non-health care professionals, including experienced lay breastfeeding support counselors, from accessing the exam.

• The IBCLC is not yet a recognizable profession in Russia – There is a certain mistrust that the profession is coming from western societies with certain rules and regulations that are not appropriate to other countries.

• Making a living as an IBCLC – is rare in Europe. Many aspiring lactation consultants question whether navigating the significant obstacles is worth the cost and effort if they cannot support themselves or their families with a job in the field.

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