29 September, 2014

The difference between a CLC and an IBCLC.

As a newly certified CLC I am coming up against some unexpected bias against my qualifications and I feel the need to process via blogging.  Hopefully this will reach others who are confused and help them to make the decisions they need to make regarding who to ask for help.  

For those who are totally unfamiliar, a CLC is a Certified Lactation Counselor.  There are also individuals who are IBCLC's, or International Board Certified Lactation Consultant.  To confuse things even more, there are also Lactation Counselors thrown into the mix.  Let's start with them.

Lactation Counselors have sought out and gained training in the area of human lactation through an organization called The Healthy Children's Center for Breastfeeding.  Lactation Counselors attend a 20 hour course that covers the basics of breastfeeding.  There is no test, no certification, no demonstration of skill.  These individuals are the front line in breastfeeding education.  Often they are  labor/delivery nurses, midwives, doulas, postpartum doulas, WIC employees, nurse assistants, LaLeche League leaders, etc.  They are a very important part of the breastfeeding support system and I cannot imagine a world without them.  These individuals are the first ones to support new moms in their breastfeeding journey, and thus often the first ones to spot a potential problem.

Certified Lactation Counselors are part of the same organization as a Lactation Counselor, but with more.  CLC's become certified after attending a 45 hour course, passing an exam, and demonstrating proficiency in practice.  Certification is through the Academy of Lactation Policy and Practice.  "CLC certification means that a person has received training and competency verification in breastfeeding and human lactation support including assessing the latching and feeding process, providing corrective interventions, counseling mothers, understanding and applying knowledge of milk production including in special circumstances and other commonly encountered situations." (http://www.healthychildren.cc/clc.htm)  In a nutshell, CLC's are qualified to help mommies and babies, even if there are some early challenges.  Often CLC's are  labor/delivery nurses, midwives, doulas, postpartum doulas, WIC employees, nurse assistants, LaLeche League leaders, etc. (see a theme?)

International Board Certified Lactation Consultants are certified through the IBLCE (International Board of Lactation Certification Examiners).  Many IBCLC's are, you guessed it, labor/delivery nurses, midwives, doulas, postpartum doulas, WIC employees, nurse assistants, LaLeche League leaders, etc.  IBCLC certification does require some higher education in the sciences.  IBCLC's are also required to attend supervision under another IBCLC.  IBCLC's are also required to pass an exam, but do not have to demonstrate proficiency in their scope.  

At the heart of each of these paths is the desire to help mamas and babies to do the work they were designed to do, breastfeed.  In all 3 disciplines evidence based practice is essential and each are expected to follow the code of ethics presented by their governing organization.  Being an IBCLC is not an implication of more experience, greater knowledge, or larger scope of practice.  

I was part of a social network group related to tongue and lip ties in babies.  I left that group after a few days when the general consensus was that CLC's were not good enough to provide support, suggestions for corrective intervention, or counseling.  This is personally disheartening, but more important, this is a dangerous myth to perpetuate.  Mothers in some communities may have only a small smattering of experts to consult if they are facing challenges.  Just like with teachers, doctors, lawyers, counselors or any other professional, not all are created equal.  The alphabet soup after a person's name should only be a guide, not seen as an absolute testament to skill and ability.  A CLC with 10 years of experience might be better equipped to solve a challenging problem than an IBCLC just coming out of supervision.  The letters mean almost nothing (a tough pill to swallow since I am so proud of my CLC achievement!).  

Here's the real kicker:  ALL of these professionals (LC, CLC, IBCLC) ARE MORE QUALIFIED TO ASSIST WITH BREASTFEEDING CHALLENGES THAN YOUR PEDIATRICIAN, MD, ENT, PEDIATRIC DENTIST.  I will let that soak in for a few minutes.  Even LC's, with their basic education in breastfeeding, are MORE QUALIFIED than your DOCTOR, to provide education, support, correction, referral to new moms who are facing nursing challenges.  

To me, this is so very important to explain to new moms.  If you are having challenges, find a professional with professional level knowledge and skills of breastfeeding.  If you don't like the person you consult with first, ask another one, and another one after that if you need to. We all bring different experiences, expertiese, knowledge, skills to our profession.  

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