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What Licensure Means for You

line Certificate for IBCLC

There are several designations that qualify as breastfeeding support and they are not all the same. Consumers, insurance companies and health care providers should be clear about these distinctions.

Former Surgeon General Regina Benjamin, in her “Call to Action for Breastfeeding Support”, states how health care providers can support breastfeeding:

  • Ensure access to International Board Certified Lactation Consultants.
  • IBCLC certification helps ensure a consistent level of empirical knowledge, clinical experience, and professional expertise in the clinical management of complex lactation issues.

The IBCLC is a rigorous training in lactation. Here’s an example: I had experience as a  certified childbirth educator for 20 years and a certified doula for ten years. In addition, I completed the 45-hour NMC counselor and the 45-hour CLC trainings. That was the start.

The application for the IBCLC exam required 90 hours of lactation specific courses, specific college level courses and, in my case, almost 2,000 hours of actual clinical experience (with an experienced IBCLC mentor). I took the exam and I passed. I earn continuing education credits and am required to take the exam every ten years.

This assures we are current with the research and provide accurate information. I believe it is the clinical hours, one on one with a mother, which are most essential.

The fundamentals of breastfeeding can be learned in a one-week course. That is an important complement for work as a doula, childbirth educator, social worker, W.I.C peer counselor. Nonetheless, there is a difference between basic and advanced training. IBCLC is advanced training.

So why does this matter? Babies who are born preterm or low birth weight, mothers with diabetes and endocrine problems, families with complex medical problems, a history of PTSD or depression, all need more than basic breastfeeding support. When a mother has challenges, and many do, she should receive the appropriate advanced breastfeeding support that she needs. Low-income families are more likely to experience complex and difficult situations.

In most of the country, however, Medicaid programs (here it is MassHealth) do not cover IBCLC support for their clients. Even for some families paying private insurance, IBCLC support is not consistently covered. How helpful is that?

Surgeon General Benjamin recognized that “A major barrier to availability is the lack of third-party reimbursement.” Many plans require health care providers to be licensed. The IBCLC (International Board Certified Lactation Consultant) credential is a certification, not a license. Ay, there’s the rub.

Lack of licensing leads to lack of  insurance coverage. Health care providers who are licensed (NPs, MDs, etc.) often do not have this much specific background in breastfeeding. It’s not really the appropriate support. We’re working to gain licensure for IBCLCs. It is one way to improve access to high quality, appropriate care.

Licensing is a state-by-state endeavor that requires legislative action and a regulatory board. Currently, IBCLCs are licensed in Rhode Island and, most recently, in Georgia. Please add your support to Project Licensure for Massachusetts.

Breastfeeding itself may seem simple, though the health and social conditions of families often are not. We want to provide equal access to advanced care for all families, Medicaid and private insurance companies.

The IBCLC qualifications are internationally consistent and rigorous, a reliable and excellent standard for licensing. Insurance companies, health care providers and every family benefits from knowing that these standards are met.

For more effective care and for public safety, please support our efforts to obtain licensure for IBCLCs.

• Mark November 5th on your calendar for our upcoming conference at Tufts.