Saturday, December 1, 2007

Underqualified, underconfident, or just tired today

So today I was wondering (and wrote an email to my midwife whom I will be apprenticing under) if maybe getting a certified Lactation Consultant degree would be something useful or valuable to my future clients. I found this online and have to admit I was surprised at how extensive this is. I remember the CLC's in the hospitals being not very useful, and certainly none of them seemed like they were nursing moms, if that makes any sense. Sure, they prattled on about perfect latch, but they were completely stumped and defensive and even accusatory when Charlie wouldn't nurse at all for his first 3 days. It took my own dear family doctor, who came in totally as a surprise to teach me about cup-feeding and spent several hours with me trying to figure out what exactly Charlie's deal was.

So I don't know. Do any of you have any advice? Is this just another field where good old wise-woman stuff has been medicalized and quantified and "Scientified" where perhaps just years of experience and reading excellent books would serve just as well if not better?

I guess maybe I am feeling sort of shy and "unqualified" to come into anyone's home as a midwife's assistant and being introduced as "This is my partner, Joy. She is nobody and has no qualifications." OF COURSE this would never really be how it went down, but still......For the first time in a long time, I feel like I wish I had some fancy Initials after my name besides an eleven year old bachelors degree.

I am really really tired this morning. Charlie was playing "I'm 3 months old" last night and I got in from the bartending gig at 12:45 am. Maybe all I am really doing here is shamelessly hoping someone will write me something corny about my M.O.M. degree and I will be forever grateful!

Gonna go make some hot tea....


Rixa said...

You don't need any fancy initials after your name, really. My suggestion is spend your time/money/effort on buying a fantastic pregnancy, birth, & breastfeeding library and read, read, read! (Or you could ILL stuff too.) Start filing away information and research you learn on the internet, so you can find it easily when people have questions for you. That IS a path to a really good education. Plus the ability to say "been there, done that--here are some ideas for you" is something you can never earn by book learning.

For example, I became a doula through DONA and while the training was interesting and fun, I didn't really learn anything new about birth--just how to be a "nice doula" in hospitals. Which in some ways, I think is a way to silence women. But that's another post...All of my best learning was reading and research I did on my own.

Housefairy said...

Thank you, Rixa!
I have a decent library now but I think this is exactly what I will do.

mama k said...

are you involved in LLL at all? If so you could train to be a "leader" It's not a degree or anything, but it is a title.
I'm going to do that as a way to help mamas. I'd love to get my CLC thing later on, but I know that that's more involved than I can do right now.

mm said...

This is Joy, AI.
Awesome Individual.
Amazingly Intellegent.

You can add any initials you want. I'll tell you this, when things went REALLY bad with my second hbac... both midwives came by the practice as apprentices (then did the Provincial exams).
The paramedics didn't even have a clue, but they came late to the party anyway =)
I own a midwifery textbook, Varney.
I'll never be a midwife, but it is so nice to just sit and read and dream some days!

Trish said...

Okay, here's a home/un- schooling mama's opinion.

You are learning more in your talking to midwives and women who've given birth, reading books and internet info, having babies and breastfeeding them, watching birth movies, (and in person births maybe once you are really in there being an assistant) - than you would ever learn in a classroom. Your real world experience is invaluable!

What a great suggestion from Rixa to organize what you learn on-line so you can access it quickly and easily!!

If your midwife suggests some classes or something, then I guess you ought to consider them. However, if she's content to bring you in with what you already have to offer - relax and go for it! Walking into this completely new situation - into strange pregnant ladies' homes - will definitely feel really weird and uncomfortable the first time, I'm sure (well, it would for me!!). But once you've been introduced and have a better feel for what your role will be I'm certain that those women will be so glad to have you on their team - and you'll wonder why you were so worried!

Yay for you!!

Kelley said...

Joy, I think the fact that you are a mom to 4 kids whom you have grown, birthed, breastfed, loved, and taught to be adorable, happy individuals really says something. What is the use of a bunch of letters if they take you away from what really matters and don't mean a hill of beans anyway. Just my opinion.

You are fabulous.

Andrea said...

Joy -- This is kind of a random place for me to post this to you, but I've been meaning to for a while... I love your writing. I love how much you have to say. And I'm actually jealous -- I have an MFA in creative writing (all this talk of letters by the name is what reminded me I wanted to say this to you) and motherhood has smacked me upside the head with the worst fog of writer's block I've ever experienced. I'm getting back in the groove on my writing, but it's painstaking and slow. I see you bust out hundreds of words full of raw brilliance off the cuff and I'm both jealous and inspired to quit moping about my writer's block and start ramming my head against it.

Anyway, tangential. BUT, I wanted to say this: if you ever need a trained eye to look at something you've written that you want submit for publication somewhere (for anything -- sentence level editing, overall structure, conceptual feedback, just a sounding board, whatever you need) I'd like to offer mine. Your poem-ish thing, the nurse's guide to managing failure, really made me want to, I don't know, encourage you, or help you, or something, because it was so very, very good, I wanted everybody I've ever met to read it, not just those of us who have found your blog. I hope this makes sense and doesn't sound weird. No weirdness intended, here.

Here's my email: lvgrrrrl-at-yahoo-dot-com. And I can send you links to some stuff I've done if you want to make sure I'm not some freak. I'm not well published (I struggle with the literary world, really), but I've done a couple things.

I'm so glad to hear that you're apprenticing to be a midwife!


Anonymous said...

Hi Joy
I have great respect for IBCLC's. They have a tremendous amount of education and on hands training. I do think there is a difference between breastfeeding support in hospital and out of hospital. In the hospitals they are very quick to supplement and discharge. There seems to be more long term goals in mind for the mom/family with outside hospital support.

I think that there is a huge amount of knowledge and experience that one gains from having four babies and nursing and being a mom. Experiential learning is not something you can get out of a book. The women you work with will see your wisdom right away.

But I also believe that this type of certification is an excellent way to get professional recognition and stable part time / full time income. I don't think it would be a waste of energy at all, and would have great paybacks. Though the training is extensive. I know two wonderful doulas, who were RN's (not your typical RN - but very strong advocates of homebirth)who studied for a whole year for the exam.

my 2cents.
-who loves your blog btw, has little time to comment, has four children also and reads from afar...

Jill said...

I would rather have a kind, caring, intelligent person who has lots of hands-on experience with peaceful birth attend me than some schmuck with a degree.

Rixa said...

I've been thinking about this more and it's not that I look down upon degrees as useless--just that most of the real intense learning I did during my PhD program was on my own and self-directed. The stuff I learned in classes, things that I had to know and read to advance in my degree, is small compared to what I learned on my own time and motivation.

So I guess I am saying: getting an official degree can be useful and really enjoyable and give you a lot of knowledge of a certain sort. And you betcha I will throw around my PhD qualifications in certain settings. On the other hand, you don't need initials behind your name in order to learn.

ps--I could send you a copy of the birth-related files I've collected over the years. It's all sorts of stuff filed away alphabetically: research studies, anecdotal experiences, interesting or inspiring ideas, and so on.

CNH said...

I've helped countless women breast feed and have no letters. I helped two who a LLL leader could not help!

YOU will be fine Mama!

Maire said...

I have enjoyed reading your blog and agree with some of the comments that followed this post.

Credentials do not make anyone an expert. Studying for the IBCLC exam may give you an overview of the subject that takes you beyond your own experiences as a breastfeeding mother.

Without any formal training you are already able to empathize and relate to the sense of overwhelm that overtakes a new mom experiencing difficulties with her breastfeeding.

I can fully understand your hesitancy in pursuing the IBCLC. I have noticed an alarming trend during these past 22 years toward a model of breastfeeding that is quite medicalized in all the wrong ways. I find that quite ironic as midwifery comes out of the ashes, breastfeeding seems to be be turning into a science project.

What I will say is that it will give you credibility for many moms to have the certification. Unfortunately some people can pass the exam and have no clinical expertise...just a lot of book learning. They sell out and push pumps, gadgets and yes, even formula to cover their lack of real skill in managing breastfeeding issues.

A lot of new moms don't understand that all lactation consultants are not the same. They assume we are interchangeable as long as we have the credentials. Much the same way as there are various types of midwifes.

Breastfeeding is not about weights and measures, but about a pain-free and loving connection between the baby and its mother.

What makes a great lactation consultant, doula, midwife or nurse is compassion, empathy and a willingness to learn from each unique experience that comes your way. We must faclitate positive experiences and not add to the mother's stress.

Sounds like you would be a breath of fresh air and a welcome ally for those of us trying to empower women around their breastfeeding experience.

If there is anything I can do to help, please drop me a line or visit my site.

Housefairy said...

Thank you, thank you, thank you everybody for indulging me in squelching so many of my insecurities. I will be taking all of these suggestion and kind words into my heart over the next few weeks and months as I begin study with my midwife mentor. Thank you thank you thank you!

Homebirth said...

Yes, what Maire said about LC's is true. Anyone can call themselves a lactation consultant; there's no required standard for how much education they need to have. So you can have a very mixed bunch of people all claiming to do the same thing.

I have heard that if you are looking for a LC, that IBCLC is the gold standard, because they really have to know their stuff. The LC you saw in the hospital was probably not an IBCLC, just the "designated person to help with breastfeeding."

Angi said...

Okay-in comes the mom who needs some breastfeeding help! This is not maybe the perfect forum but I've been ruminating on a problem I'm having, and reading all this made me really want help from all you lovely ladies.

I went in for my baby's well check. She is 10 months old, and our last visit was her 6 month. The problem I was presented with is that she hasn't gained any weight in four months, at all. (She eats about two meals of baby food, crackers, some water in a cup and a bottle when we get a sitter and she nurses whenever she 'demands'. Maybe 5 times a day)

After asking me a couple questions, the doc said "sometimes I just don't know about these moms who keep puttering on with the breastfeeding. I just wonder if they are really providing any caloric benefit at all".

I don't know what to think and I haven't found any answers online. Is it true that the caloric value of what I'm doing is useless? Is there something different I should be doing, taking more vitamins or nurse less and feed more solids, or something else? She is my fourth baby. I shouldn't let this shake my confidence but I want to do what's best for her and I'm not sure what that is.

Housefairy said...

First of all, you know this guy was rude in his complete and utter lack of actually helping you or your baby. You know that. So...while you are asking around for a new, enlightened, kind and useful doctor in your is my fledgling advice:

I know ten month olds are active, VERRY acrobatic at the breast, busy busy busy. Sometimes these babies forget to nurse, so busy are they in pulling up and walking around the edge of the couch, crawling, chewing on toys, exploring. They seem to be such different people than they were at six months when there wasn't much else to do besides nurse nurse nurse (six months was the absolute pinnacle of chubbiness for all of my kids!) That perhaps you will need to carve out more times a day that are specifically for nursing. Yep, I said, it, push beyond "demand" feeding and actually go lay down, sit down, whatever and tell baby "It is nursey time". See what happens. I know that with 4 little ones, the days of the quiet glider chair can seem long gone, but there still might be times and ways that you can slow down and carve out more time for nursing with your little one, you might just have to get creative.

I think five times a day sounds very very low. I was nursing five times a morning many days. Do you feel engorged or like you could nurse more but there is a lack of interest by the busy baby? I have had great success in using some of Motherlove Herbals tinctures for increasing milk supply, takes about 2 days to notice the baby really "glug-glugging" and doesnt tast too great, but not too horrible either. Lots of companies offer tinctures and formulas to increase supply, some claim to "fortify and enrich" the milk, too. Dont know if that is true or possible but sounds cool and gives me a nice feeling when I read that! I have used HerbPharm and Motherlove. They have tinctures for pregnant nursing women also. Teas are great but tinctures are really strong and fast.

I wouldnt worry too much about snacking and little crackers and whatnot but at 10 motnhs, for most children, solid foods are still a fun texture-experiment and not their main sorce of calories. I once read that until 12 months you offer nursey first, then solids. After 12 months you can offer solids first, then nursey. I must say, however, that life for us was never this black and white after the first baby, and there was nursing and snacks all around all the time and I never really got that formal. It doesnt sound as if you are night-nursing if it is five times a day, but is this something you would consider? Sleep is so important and 10 months was right around when we had our kids out of our bed and into cribs but every baby is different and for some babaies, nighttime is when they can really get down some good quantities of milk...

All of this aside, your baby might just be "thinning out". It is probabaly unusual to not gain any weight, but I know my own children really thinned out after they could crawl, with about 5 or 6 months being the peak of roly-polyness.

I wonder if this guy thought he helped you and your child with his dismissive rudeness, judgemental disdain and overall lack of knowledge about infant nutrition. Are you the type who would feel comfortable writing them a letter? Maybe even a few months or years down the road? Oh how I wish I had written to all the doctors who told me my milk was bad, my child needed sugar water, my kid was too fat or too thin, or that I needed to "get em on a bottle".

Thank you for this first chance to give advice on the blog. Email me if you want, and please tell us if any of this worked. Please tell me if any of this helped at all because if not I can look up more things online and in my books for you.

Oh- and most importantly of all-- are YOU worried about your baby? Or was this guy and his scale and his attitude what has you the most concerned?

Housefairy said...

DO NOT nurse LESS. If that wasnt clear, thats the one thing I would say for sure!

Angi said...

Joy-thank you! I am going to have to read your response a couple times to take it all in. I am so glad you responded because I was out with a friend today telling her about the weight thing and I said something like "yeah I don't know what to think because I nurse her whenever she seems hungry" and she responded "You SURE do! You are a nursing machine!!!" (And not in an 'I'm really impressed' sort of way). I was starting to question myself a little-- (BTW, after she started "bragging" about how her babies were on three hour feeding schedules my nine year old son replied "Uh, we're more 'go with the flow'" :)

Okay, 5 is probably a little low but about accurate, she doesn't nurse at night anymore, she's sleeping all night in her crib now (just started about two weeks ago). I never get engorged though, except in the morning at her first feeding. I wonder if that's a problem. I'll definitely look into the tinctures. Do you get them over the internet?

I decided earlier today something you hit on in your post, I wasn't at all worried about her until I went into the doc. I am going to really just try to trust our relationship, and my instincts. I definitely will push the nursing more too.

I may have more questions later. I'll e-mail you directly. Thank you!

Rixa said...

I have definitely noticed that my daughter nurses more when I go upstairs and lie down on the bed with her, versus just sitting on a couch/chair downstairs in the middle of normal life. So yes, as much as you can with little ones tumbling around, try to sneak off and have quiet nursing sessions where she isn't distracted.