Lactation consultation

There are many things that "they" don't tell you about before you become a parent. You know, things like how often you have to trim tiny baby fingernails, the fact that you'll be lucky to squeeze your one-month-old into 0-3 month clothing, and that babies aren't born knowing how to be breastfed. It may look natural, but they have to learn how to do it right, and until they do it can be a frustrating and (take Tiffany's word for it) painful experience.

That's where lactation consultants come in. We were fortunate that our doula was also qualified to assist in this matter, but a reliable resource isn't always available. In fact, the term "lactation consultant" is an unofficial one that doesn't require a person calling herself that to have any specific training or background.

There's a bill in the Lege, HB703 by Reps. Mike Villarreal and Jessica Farrar, that would define the term and put some restrictions on its use. Here's a blurb from the Central Texas Healthy Mother Healthy Baby Coalition in support of HB703:

The Lactation Consultant Licensure bill, HB 703, is a title protection act, which means it restricts the use of the term "lactation consultant" (LC) to individuals specifically trained in lactation management. It does not restrict unlicensed individuals from helping mothers with breastfeeding.

Currently, LCs are certified by the International Board of Lactation Consultant Examiners. To obtain IBLCE certification, the individual must complete education specific to lactation science, complete a specific number of hours helping breastfeeding mothers and babies, and pass an exam to test their knowledge. They are also required to complete 75 hours of continuing education within 5 years, and to re-certify by examination at 10 year intervals to demonstrate continued competence. HB 703 describes this process. The intent of HB 703 is to augment LC certification with state licensure so that consumers will be able to 1) identify trained lactation consultants, and 2) have a place to lodge complaints locally in the event of bad or unethical care.

The Texas Medical Association and the Texas Pediatric Society have decided to oppose HB 703. Currently, the policy of the TMA and other medical professional organizations is to block the establishment of any new health care professions. The rationale for this is several-fold, but appears also to include concern over shrinking shares of medical dollars. While this position benefits physicians, it does not benefit consumers.

TMA also argues against the bill on the basis that physicians should be able to provide lactation care without being licensed as LCs. HB 703 does not require physicians to become licensed as LCs in order to do so. The bill also specifies that nurses do not have to be licensed LCs to provide lactation care. The bill would provide title protection but not practice protection. That is, anyone who holds themselves out as a Lactation Consultant would have to be licensed as an LC, but LC licensure would not be required to simply help a mother with breastfeeding.

A somewhat wordier version of that is here. Unfortunately, HB703 is currently pending in the Public Health committee, where it may die without ever being heard on the floor if nothing happens soon. If you think this is a good idea, and especially if your State Rep is on the Public Health committee, please contact them and let them know that you'd like to see the House take action on this. Thanks very much.

Posted by Charles Kuffner on April 27, 2007 to That's our Lege