550865
research-article2014
JHLXXX10.1177/0890334414550865Journal of Human LactationPayne
FastTrack: Commentary
A Call to Action: Lactation Equity through Professional Diversification
Journal of Human Lactation 2014, Vol. 30(4) 396–397 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0890334414550865 jhl.sagepub.com
Sherry L. Payne, MSN, RN, CNE, IBCLC, CD(DONA)1 Keywords barrier, breastfeeding, diversity, equity, IBCLC credential, International Board Certified Lactation Consultant
On July 27, 2014, in Phoenix, Arizona, the International Lactation Consultant Association (ILCA) held a historic meeting following their annual conference. The topic being explored was diversity within the profession of International Board Certified Lactation Consultants (IBCLCs). The outline of the day was a simple one: listen to the stories of underrepresented groups as they talked about the unique barriers they faced in seeking the IBCLC credential. As meeting facilitator, it was important to honor the difficult work inherent in listening. It was an emotional day and some walked away feeling deeply grieved by the stories they heard of others’ wounds. There were powerful stories shared that were skillfully rendered. We heard from Brandi Gates, an African American IBCLC who was told that she and 3 African American Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) peer counselor coworkers would not know enough to pass the test, and when all 4 did pass, the 1 IBCLC job opening available was given to someone brought in from the outside, someone Caucasian. Native American Camie Jae Goldhammer, MSW, IBCLC, spoke eloquently on the generational harm that can reverberate through families when breastfeeding is disrupted. She traced her family history back 7 generations to share where the breastfeeding lineage was disrupted and how the breach stopped with her nursing her own babies. She spoke of generational negative health outcomes that coincide with breastfeeding cessation. Each new story seemed to rip open an old and seemingly forgotten wound. The meeting was hosted jointly by ILCA, the International Board of Lactation Consultant Examiners, and the Lactation Education Accreditation and Approval Review Committee. It was planned by Design Team Chairs Cathy Carothers, BLA, IBCLC, FILCA, and Judi Lauwers, BA, IBCLC, FILCA, and 17 other lactation professionals who made up the design team (listed in Acknowledgments). Cynthia Good Mojab, MS, LMHCA, IBCLC, RLC, CATSM, contributed an excellent pre-summit webinar sponsored by Gold Lactation Online Conference titled “Ready, Set, Listen:
Preparing to Hear the Missing Voices of the Lactation Consultant Profession.” The title aptly captures the spirit of anticipation, preparation, and hope that is inherent in this type of forum. We heard not only from African Americans, Native Americans, Latinas, and LGBTQ community members from the Americas but also from Europeans, Australians, Chinese, and Japanese, among others. It was a privilege to hear the stories of IBCLCs and aspiring IBCLCs from around the globe. There were voices that were not present—notably, none from Africa or the Middle East. Even so, there were common threads that revealed themselves throughout the day, the main one being that the IBCLC credential is not very accessible to those who are not American, White, and privileged. This can be a difficult truth to hear for those who feel that they have worked hard for and earned their credential by their own merit. Many find it difficult to believe that there are barriers if they themselves do not experience them. Only through compassion, empathy, and a spirit of reconciliation can this gap be bridged. This meeting stands as a clarion call that we must diversify the ranks of IBCLCs because the needs of breastfeeding women worldwide demand it. Making professional lactation care and support available to underserved communities is a closely connected issue—one initially addressed by the 2013 Inequities in Breastfeeding Support Summit in Seattle, Washington. Change needs to happen at every level—personally, interpersonally, institutionally, Date submitted: August 3, 2014; Date accepted: August 12, 2014. FastTrack papers are considered high impact. After peer review, we speed up their publication so JHL readers can access important new information as soon as possible. FastTrack papers may not always be related to themed content in special issues. 1
Uzazi Village—Administration, Kansas City, MO, USA
Corresponding Author: Sherry L. Payne, MSN, RN, CNE, IBCLC, CD(DONA), Executive Director, Uzazi Village—Administration, 3647 Troost Avenue, Kansas City, MO 64109, USA. Email: [email protected]
Downloaded from jhl.sagepub.com at FLORIDA INTERNATIONAL UNIV on June 5, 2015
397
Payne and structurally. The conversation has begun. It should now become the quest of all our professional lactation support organizations to find ways to make the credential more accessible to those who seek it. There needs to be certification pathways that create bridges for all levels of lactation support personnel. We must all work together to find ways to make this credential more accessible to those communities that are in the greatest need of it. There is much concern that greater access means less stringent standards for acquiring the credential. This need not be the case. Accessibility and high standards for the credential need not be mutually exclusive. As one who works in the trenches with low resource women of color who daily suffer the indignities of deficient lactation support (of any kind), ongoing low rates of breastfeeding, and a gross lack of culturally congruent lactation care, I must call for decisive action. We need the moral fortitude to pursue what is ultimately best for all breastfeeding mothers and babies. While we fight among ourselves to vie for first place in credentialing, another mother quietly chooses to stop breastfeeding, not because she wants to, but because she cannot access the resources she needs to be successful. This is a complex and multilayered issue. There will be no quick fixes or easy answers. When ILCA next meets in Washington, DC, in 2015, it is my hope that the stories shared will be ones that demonstrate movement toward openness and connectedness of mind, heart, and spirit. Let us work together toward the goal of a profession that reflects the diversity found in the populations we serve. Let us serve, not just a privileged few, but all breastfeeding mothers and babies who rely on expert lactation support for their success.
Acknowledgments Thank you to the Lactation Summit Design Team. Name Cathy Carothers Judi Lauwers Cheryl Benn Liz Brooks Becky Mannel Sara Lake Sherry Payne Joshua Johannsen Kiddada Green Regina Roig-Romero Euphemia John Cynthia Good Mojab Phyllis Kombol Yuwen Ren Maya Bolman Kathy KendallTackett Gwen Moody Carole Dobrich Jeanette McCulloch
Organization Chair; Every Mother, Inc Lactation Education Accreditation and Approval Review Committee (LEAARC) LEAARC International Lactation Consultant Association (ILCA) International Board of Lactation Consultant Examiners (IBLCE) IBLCE Uzazi Village Reaching Our Sisters Everywhere (ROSE) Black Mothers’ Breastfeeding Association Miami-Dade Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program Cherokee Nation WIC Program LifeCircle Counseling and Consulting, LLC ILCA Clinical Instruction Subcommittee Lactation educator (China) Lactation consultant (Russia) US Lactation Consultant Association (USLCA) Lactation Consultants of Australia/New Zealand (LCANZ) Health-e Learning ILCA media coordinator
Declaration of Conflicting Interests The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding The author received no financial support for the research, authorship, and/or publication of this article.
Downloaded from jhl.sagepub.com at FLORIDA INTERNATIONAL UNIV on June 5, 2015
research-article2014
JHLXXX10.1177/0890334414550865Journal of Human LactationPayne
FastTrack: Commentary
A Call to Action: Lactation Equity through Professional Diversification
Journal of Human Lactation 2014, Vol. 30(4) 396–397 © The Author(s) 2014 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/0890334414550865 jhl.sagepub.com
Sherry L. Payne, MSN, RN, CNE, IBCLC, CD(DONA)1 Keywords barrier, breastfeeding, diversity, equity, IBCLC credential, International Board Certified Lactation Consultant
On July 27, 2014, in Phoenix, Arizona, the International Lactation Consultant Association (ILCA) held a historic meeting following their annual conference. The topic being explored was diversity within the profession of International Board Certified Lactation Consultants (IBCLCs). The outline of the day was a simple one: listen to the stories of underrepresented groups as they talked about the unique barriers they faced in seeking the IBCLC credential. As meeting facilitator, it was important to honor the difficult work inherent in listening. It was an emotional day and some walked away feeling deeply grieved by the stories they heard of others’ wounds. There were powerful stories shared that were skillfully rendered. We heard from Brandi Gates, an African American IBCLC who was told that she and 3 African American Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) peer counselor coworkers would not know enough to pass the test, and when all 4 did pass, the 1 IBCLC job opening available was given to someone brought in from the outside, someone Caucasian. Native American Camie Jae Goldhammer, MSW, IBCLC, spoke eloquently on the generational harm that can reverberate through families when breastfeeding is disrupted. She traced her family history back 7 generations to share where the breastfeeding lineage was disrupted and how the breach stopped with her nursing her own babies. She spoke of generational negative health outcomes that coincide with breastfeeding cessation. Each new story seemed to rip open an old and seemingly forgotten wound. The meeting was hosted jointly by ILCA, the International Board of Lactation Consultant Examiners, and the Lactation Education Accreditation and Approval Review Committee. It was planned by Design Team Chairs Cathy Carothers, BLA, IBCLC, FILCA, and Judi Lauwers, BA, IBCLC, FILCA, and 17 other lactation professionals who made up the design team (listed in Acknowledgments). Cynthia Good Mojab, MS, LMHCA, IBCLC, RLC, CATSM, contributed an excellent pre-summit webinar sponsored by Gold Lactation Online Conference titled “Ready, Set, Listen:
Preparing to Hear the Missing Voices of the Lactation Consultant Profession.” The title aptly captures the spirit of anticipation, preparation, and hope that is inherent in this type of forum. We heard not only from African Americans, Native Americans, Latinas, and LGBTQ community members from the Americas but also from Europeans, Australians, Chinese, and Japanese, among others. It was a privilege to hear the stories of IBCLCs and aspiring IBCLCs from around the globe. There were voices that were not present—notably, none from Africa or the Middle East. Even so, there were common threads that revealed themselves throughout the day, the main one being that the IBCLC credential is not very accessible to those who are not American, White, and privileged. This can be a difficult truth to hear for those who feel that they have worked hard for and earned their credential by their own merit. Many find it difficult to believe that there are barriers if they themselves do not experience them. Only through compassion, empathy, and a spirit of reconciliation can this gap be bridged. This meeting stands as a clarion call that we must diversify the ranks of IBCLCs because the needs of breastfeeding women worldwide demand it. Making professional lactation care and support available to underserved communities is a closely connected issue—one initially addressed by the 2013 Inequities in Breastfeeding Support Summit in Seattle, Washington. Change needs to happen at every level—personally, interpersonally, institutionally, Date submitted: August 3, 2014; Date accepted: August 12, 2014. FastTrack papers are considered high impact. After peer review, we speed up their publication so JHL readers can access important new information as soon as possible. FastTrack papers may not always be related to themed content in special issues. 1
Uzazi Village—Administration, Kansas City, MO, USA
Corresponding Author: Sherry L. Payne, MSN, RN, CNE, IBCLC, CD(DONA), Executive Director, Uzazi Village—Administration, 3647 Troost Avenue, Kansas City, MO 64109, USA. Email: [email protected]
Downloaded from jhl.sagepub.com at FLORIDA INTERNATIONAL UNIV on June 5, 2015
397
Payne and structurally. The conversation has begun. It should now become the quest of all our professional lactation support organizations to find ways to make the credential more accessible to those who seek it. There needs to be certification pathways that create bridges for all levels of lactation support personnel. We must all work together to find ways to make this credential more accessible to those communities that are in the greatest need of it. There is much concern that greater access means less stringent standards for acquiring the credential. This need not be the case. Accessibility and high standards for the credential need not be mutually exclusive. As one who works in the trenches with low resource women of color who daily suffer the indignities of deficient lactation support (of any kind), ongoing low rates of breastfeeding, and a gross lack of culturally congruent lactation care, I must call for decisive action. We need the moral fortitude to pursue what is ultimately best for all breastfeeding mothers and babies. While we fight among ourselves to vie for first place in credentialing, another mother quietly chooses to stop breastfeeding, not because she wants to, but because she cannot access the resources she needs to be successful. This is a complex and multilayered issue. There will be no quick fixes or easy answers. When ILCA next meets in Washington, DC, in 2015, it is my hope that the stories shared will be ones that demonstrate movement toward openness and connectedness of mind, heart, and spirit. Let us work together toward the goal of a profession that reflects the diversity found in the populations we serve. Let us serve, not just a privileged few, but all breastfeeding mothers and babies who rely on expert lactation support for their success.
Acknowledgments Thank you to the Lactation Summit Design Team. Name Cathy Carothers Judi Lauwers Cheryl Benn Liz Brooks Becky Mannel Sara Lake Sherry Payne Joshua Johannsen Kiddada Green Regina Roig-Romero Euphemia John Cynthia Good Mojab Phyllis Kombol Yuwen Ren Maya Bolman Kathy KendallTackett Gwen Moody Carole Dobrich Jeanette McCulloch
Organization Chair; Every Mother, Inc Lactation Education Accreditation and Approval Review Committee (LEAARC) LEAARC International Lactation Consultant Association (ILCA) International Board of Lactation Consultant Examiners (IBLCE) IBLCE Uzazi Village Reaching Our Sisters Everywhere (ROSE) Black Mothers’ Breastfeeding Association Miami-Dade Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program Cherokee Nation WIC Program LifeCircle Counseling and Consulting, LLC ILCA Clinical Instruction Subcommittee Lactation educator (China) Lactation consultant (Russia) US Lactation Consultant Association (USLCA) Lactation Consultants of Australia/New Zealand (LCANZ) Health-e Learning ILCA media coordinator
Declaration of Conflicting Interests The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding The author received no financial support for the research, authorship, and/or publication of this article.
Downloaded from jhl.sagepub.com at FLORIDA INTERNATIONAL UNIV on June 5, 2015
