There’s a lot of hoopla in the field of lactation, specifically regarding credentialing, licensure, and reimbursement for lactation professionals, as we work to integrate lactation care into the healthcare industry. I’ve seen and heard and been a part of many conversations about the various roles/providers and how they fit into the very new and still blossoming field of the lactation. The United States Lactation Consultant Association (USLCA) has advanced the lactation consultant profession in such as way as to promote and protect breastfeeding collaboratively, with integrity and diversity, and has positioned the International Board Certified Lactation Consultant (IBCLC) as the preferred “stand-alone” (not otherwise possessing a healthcare license) provider to care for breastfeeding mother-baby pairs.
We all know that breastfeeding is important. How we nourish our offspring when they’re young, in mind, body, and spirit, lays the footprint for their entire experience on Earth. It has social, environmental, and economical implications beyond the individual, as well. Breastfeeding IS a biological imperative that is necessary for the natural evolution of our species. I feel very strongly that we must support it as much as possible…for every human being. There are various breastfeeding helpers available to reach every family, to provide truly individualized support and care and each helper reaches families in a different way. It is a beautiful thing that families have such a variety of ways to receive breastfeeding help from such diversified providers!
In the United States, we are consumers of healthcare: the care of our bodies is provided mostly by a medical model that is heavily influenced by a complex financial and bureaucratic system. It makes sense, then, that if we are to truly influence breastfeeding in society, we *must* reach families where they obtain their healthcare services. And in order to assimilate the very young field of lactation into these services, we need a standardized profession that is accompanied by an appropriate scope of practice and training programs that provide not only academic but clinical experience. Establishment and recognition of such a profession by the medical model protects the public by ensuring proven training and education of providers.
Such a profession already exists: the IBCLC. For some reason, I catch a lot of flack when I say this, as if I’m offering an elitist point of view: among the myriad of lactation credentials, the IBCLC is the only lactation credential with a required clinical component in addition to academic study and independent testing. For this simple fact alone, I believe it to be the best fit for licensure and integration into the medical model. That is not an elitist view, but rather a pragmatic one. What other medical profession exists that does not have clinical training as part of its entry-level requirements? What other medical profession exists that does not require proof of knowledge by testing? Or continuing education? As a “stand alone” certification with extensive and rigorous pre-requisites, the IBCLC is perfectly poised for immediate integration into the healthcare model as the “breastfeeding management” member of the mother-baby healthcare team.
Does that mean that I believe that other breastfeeding helpers cannot provide effective lactation care? No. Does that mean I want to prevent other breastfeeding helpers from supporting families? No. Or that I want to restrict access to care for families? Absolutely it does not! Nor does it mean that I feel IBCLCs are “superior” in any way.
It simply means that they have had hands-on, supervised training (in a variety of settings), have successfully pursued appropriate education, have demonstrated their knowledge to a certifying body, have agreed to operating within a defined scope of practice as defined by their professional association, and have committed to on-going efforts to remain abreast of current evidence specific to the burgeoning field of lactation…just like every other healthcare profession within the medical model.
Presently, I’m seeing conversation taking place among lactation care providers, breastfeeding helpers, and other interested parties regarding HCPCS codes and Medicaid reimbursement. It disappoints me that some of the conversation is fostering negativity and competition. At our core, aren’t we all in this for the same reason? Why are we speaking against each other instead of WITH each other? We needn’t compete with each other to “further the cause”; the demand for breastfeeding help far exceeds what we’re currently able to supply!
USLCA and its members have been working to integrate lactation care into the healthcare industry. Volunteers within the association have not only been pioneers in the field of lactation, but have committed thousands of hours to working with government agencies, legislators, insurance companies, providers, researchers, and advocates to advance the role of the IBCLC within the United States. I highly encourage those providers who are interested in licensure and reimbursement of lactation professionals to join the conversation, join the association, become an IBCLC. Opportunity in the field of lactation abounds! Let’s use our meaningful ideas and passionate energy to integrate lactation care and ensure adequate breastfeeding support for generations to come.
*I apologize that this website is not configured to allow comments. If you would like to engage in conversation, please reach out to me on my Facebook page or join other breastfeeding supporters in the United States Lactation Consultants Association, the professional association for IBCLCs and other health care professionals who care for breastfeeding families.*
Melissa Morgan, IBCLC, RLC, LE is a private practice International Board Certified Lactation Consultant providing breastfeeding help and education for families in Eastern Washington and North Idaho. She is also available for contractual in-clinic lactation consulting. She has been helping families with breastfeeding since 1999 and is a member of the United States Lactation Consultant Association.