Thoughts on IBCLC training, reimbursement, and where the profession is headed

I don't remember when I first realized that the profession of "lactation consultant" existed. I must have encountered it at some point doing research for my undergrad senior thesis, which was (to make it very brief) a literature review and mixed-methods study on infant feeding decisions. The following year, when I did AmeriCorps, was my real introduction to the world of breastfeeding support: I did a 3-day training to become a Certified Breastfeeding Educator (taught by an IBCLC), began doing breastfeeding support in the clinics, and did some shadowing with in-hospital IBCLCs. That experience made me realize that I wanted to be an LC. One of my absolute favorite parts of the job was doing breastfeeding support, and I liked what I saw the LCs that I worked with getting to do. I enjoyed the one-on-one interaction, the clinical problem-solving, the feeling that you were working to help the mother achieve something that was important to her, and the satisfaction when something you suggested worked and - click! - for the first time, mom and baby had a successful feeding.

At the time, though, I looked into becoming an LC and couldn't imagine a way to get enough hours. At the time, IBLCE (the certifying organization for LCs) required thousands of hours of clinical practice to be eligible to sit the exam (for an interesting historical overview of IBCLC eligibility requirements, check out this presentation - opens as a PDF). When I was looking, the requirement was 2500 hours of clinical practice, which I would have to find a way to get independently (since apart from my one-year AmeriCorps term which was already over, I didn't have a job where I could get hours that would count towards my eligibility).

And I really considered how to make it happen. For years, I wanted to become an LC, and I would investigate ways to do it, and then I would give up again. And in this post I'm going to talk about why.

I've been putting off, mulling over, composing and revising this post for a long time. The seeds were sown when I first heard about the new requirements to sit the IBCLC exam, and when I read debates on Lactnet and other listservs; I've gotten e-mails and read other people's posts about this issue; but it's taken a while for me to figure out my thoughts about it.

The impetus to finally put this out there was sparked by some conversations I had at the Breastfeeding & Feminism conference with IBCLCs and IBCLC-wanna-bes. The wanna-bes talked with me about the difficulty of finding and funding training, the IBCLCs talked about their awareness of that difficulty, the limitations of the LC community in addressing the shortage of good training, and the issues with the current pathway system.

This is my current thinking and I'm very curious to hear what others think about it. I apologize for the length - it's quite possible it could be shorter and more succinct, but if I spend too much more time revising it will never get posted!

To start off, a little background about how you become an IBCLC: historically, there have been different pathways to qualifying to sit the exam. They have changed names and requirements more than once, but in my understanding they've all fallen under more or less two different routes:

1) Becoming an IBCLC already having some kind of medical/nursing/clinical degree. To qualify to sit the exam, these people have to have some lactation-specific education (although it is not standardized - hours from a vast array of providers and topics can count), and they also have to meet a minimum number of hours spent working with breastfeeding dyads. Importantly, these hours do not need to be under the direct supervision of an experienced IBCLC and can happen as part of the professional's regular work. So a nurse on a postpartum floor, a pediatrician, a dietitian at a WIC office - all of these people may be able to get their minimum hours through their work. (Pathway 1 in the current system.)

2) Becoming an IBCLC without having any kind of clinical degree. To qualify to sit the exam, these people have to also have lactation-specific education, and they need to meet a minimum hours requirement. However, their minimum hours need to be completed under the mentorship of one or more IBCLCs who have recertified at least once. (Pathway 3 in the current system.) These people can also do an educational program approved by IBLCE (Pathway 2), which provides the mentoring, hours, etc. all in one package, and requires somewhat fewer minimum hours, but those programs are few and far between.

Starting with those who will sit the exam in 2012, IBLCE is changing the requirements. From their information page on the upcoming changes:

IBLCE has identified eight subjects in which all first-time candidates must have completed the equivalent of one semester of higher education. These 8 higher education courses are:

* Biology
* Human Anatomy
* Human Physiology
* Infant and Child Growth and Development
* Nutrition
* Psychology or Counseling or Communication Skills
* Introduction to Research
* Sociology or Cultural Sensitivity or Cultural Anthropology

In addition, all first-time candidates must have completed continuing education in 6 subjects that health professionals typically will have studied as part of their professional training and/or are required for ongoing maintenance of their professional credentials. These 6 additional general education subjects are:

* Basic life support (e.g. CPR)
* Medical documentation
* Medical terminology
* Occupational safety, including security, for health professionals
* Professional ethics for health professionals (e.g. Code of Ethics)
* Universal safety precautions and infection control

The discussions I've seen online have covered a range of reactions. A lot of people are very upset about the new requirements. They argue that requiring all this essentially requires you to become an RN if you want to become an IBCLC (almost all of these are either required in nursing school or required prerequisites for nursing school). Some individuals from other countries have noted that there simply is no way for them to take these courses - they don't have community colleges or schools where you can just take a few credits here and there - unless they actually do enroll in a full-time academic program to become a nurse. Additionally, some people feel that lactation consulting is already becoming overmedicalized and is moving away from its unique roots in peer counseling, focus on empowering the mother, and in helping mothers find their own solutions vs. prescriptive "treatment", and this is accelerating that trend.

Other people are very supportive of the new requirements - even some people who came up through old, non-clinical pathways. They argue that if IBCLCs want to become respected as a clinical practice specialty, they need to have requirements that parallel other clinical degrees. MDs, RNs, OTs, PTs, etc. etc. - none of them begin practice, and most don't even begin their training, without taking basic courses in biology and anatomy, nor should they. An IBCLC who doesn't understand fundamentals of nutrition shouldn't be counseling a mother about appropriate complementary foods, and an IBCLC who can't read and communicate in medical terminology and documentation won't be respected by other clinical professionals that s/he is expected to work with.

IBLCE addressed some of these concerns directly in their FAQs page about the new requirements:

17. With these new requirements, it seems to me that IBLCE is discouraging those of us who are not health professionals from becoming IBCLCs. I know of several IBCLCs in my community who are not health professionals and they are well respected. Why has IBLCE placed so much focus on the new general education requirements?
IBLCE continues to support the long-standing practice of welcoming and encouraging practitioners, who are not health professionals, to prepare and become IBCLCs. The ability to actively listen and take the time to collaborate with mothers in developing an appropriate care plan and the dedication to supporting families beyond the early postpartum period are some of the well-developed competencies of candidates who are not health professionals.

As the lactation consultant profession has matured, it has become clear that it is necessary for all IBCLCs to be well-grounded in those subjects that are typically studied by health professionals. A strong foundation of knowledge in the health disciplines that are typically included in health profession curricula will position all IBCLCs to function as well-respected members of the maternal-child health team. In addition, employers and policy-makers will have increased confidence in the IBCLC credential. With this increased confidence in place, initiatives such as licensure, reimbursement and more jobs for IBCLCs are more likely to be successful.

22. I'm an experienced IBCLC and hold no other credential in the health professions. If I were not already certified, I would not be able to qualify for the 2012 exam without returning to school. This does not seem fair and it appears that IBLCE is discouraging non-health professionals from applying. Did the IBLCE Board take this concern into consideration before making the changes?
Yes. The IBLCE Board gave quite a bit of consideration to your particular concern. In fact, there are a number of Board and staff members who are IBCLCs that hold no other credential in the health professions. The IBLCE Board holds the mother support background in such high esteem that the IBLCE By-laws require that no less than 51% of Board members have experience in mother support leadership. In spite of concerns similar to yours being expressed, the consensus of opinion was that improving the quality of the IBCLC credential was of utmost importance. The Board voted overwhelmingly to support the changes.

I see both ways on the new requirements piece. Unfortunately there are a lot of LCs out there who don't know what they're doing. And unfortunately I don't think it has very much to do with their educational backgrounds.

The way I see it, there are bad LCs out there who have medical backgrounds and never bothered to do more than count up their contact hours with mothers/babies and study for the exam, without doing any training with other LCs to improve their skills/knowledge base. There are also bad LCs out there who don't have medical backgrounds and did their training without understanding important basics of anatomy, physiology, how to read research, etc. and who have never pushed themselves to improve their skills/knowledge. (There are also bad LCs out there who have great education/experience through whatever pathway and are just bad. There are also bad doctors, nurses, etc. etc. - being able to get through a rigorous educational program and pass a test does not, unfortunately, necessarily make you good at your profession. Sigh.)

But I believe that all the challenges these new requirements pose for IBCLCs-in-training - in the U.S. at least - have less to do with the requirements themselves, and more to do with the educational pathways available. And in the end, it all comes inevitably back to licensure and reimbursement. How? Let me explain:

It may be standard and reasonable for RNs, MDs, PTs, etc. etc. to have these courses as prerequisites or as part of their professional education. However, they are generally not expected to come up with the entirety of their professional education on their own. They have educational programs which provide at least some of their educational requirements, along with things like student loans, work-study positions, fellowships, or other structured financial assistance that helps students get through their education without having to pay for it all up-front, out-of-pocket.

This is not true of IBCLCs-in-training. Along with all of these distribution requirements, they need to pay for 90 hours of IBLCE-certified lactation education (under the old requirements 45 hours). This education - which can be conferences, online courses, in-person workshops, etc. - is not cheap. Finally, they often have to pay private IBCLCs for mentorship (if they can even find one – frequently a very challenging undertaking, one of the main reasons being that the private LC is essentially training her own competition). Understandably, mentor IBCLCs need to be compensated for the extra time and effort they put in for teaching. This is another chunk of change.

When you look at all that, you are looking at a significant amount of $$$ to become an LC. (You are also looking at the exact reason that even though becoming an LC was my dream from the moment I met one, I never did it on my own. We'll get back to this in a moment.)

There are a very small number of IBLCE approved educational courses that provide a really standardized, all-in-one education the way a medical or nursing school does: you get your clinical education and your clinical rotations in a package. If they're through an accredited institution, you might even be able to get student loans to help pay for it.

This type of program was how I managed to finally get IBCLC training, because one happened to get started at my school while I happened to be there. This is why I was so excited and honestly in awe of the fact that I was getting to become an IBCLC. Why was it so amazing to me? Why did I hold off pursuing this dream?

And this is where we get back to licensure and reimbursement. (I know this is U.S.-centric, but the U.S. has a pretty large percentage of LCs and I think that LCs face this issue to varying degrees around the world. It's also one of IBLCE's justifications for changing the requirements.) Many people who look at the new requirements have said something along the lines of "Then I might as well go ahead and become a nurse". Why would they say that if they want to become LCs? Because nurses get paid. Nurses are part of standard care in a hundred different practice settings, they are licensed, and what they do is reimbursable through insurance. This is among the reasons that non-RN IBCLCs are not generally hired by hospitals, pediatric practices, etc. and among the reasons that private practice IBCLCs have trouble making a living. (The US Lactation Consultants Association has an excellent white paper on reimbursement - particularly relevant are pages 14-15).

There was no way I could justify, to myself, sinking thousands of dollars into an education that would take years and lead to a profession that could probably never be my sole source of financial support. I most definitely couldn't justify paying out-of-pocket for all that education or figure out a way to do it without decimating my future financial health and again - for what?

I think that the solution to all of these problems - training, education, experience, or lack thereof - is to have more standardized educational programs available through accredited schools. But I imagine schools, if/when they consider offering IBCLC training programs, will have financial concerns similar to the ones I had when contemplating the certification. Will they really have enough students willing to pay the amount of money needed to sustain those programs, now that these programs are about to get a lot more expensive?

The bottom line to me: you can get people to pay for years of nursing school, med school, etc. because they know they can pay back those loans eventually, and support themselves. The same promise is not there with LC work and until it is, more and more stringent educational requirements make it harder and harder for people to get into the profession without having some other professional credential that will get them reimbursed fairly for their work. An MPH student (not an RN) asked me at the conference whether I would recommend her doing the IBCLC course next year and because the cost of it has risen so much since I took it, I honestly couldn't give her a strong "yes" unless she is willing to commit to a life of private practice. She pointed out that I have a hospital position, but I assured her that I got it basically through sheer luck and those positions are few and far between.

I get that IBLCE is aiming for that eventuality of licensure and reimbursement and that they're hoping that changing the requirements will be a step in that direction. They say as much in the FAQs:

15. These new requirements will make becoming an IBCLC even more expensive. Are the IBLCE Board members concerned that the new requirements will reduce the number of applicants who are eligible to become IBCLCs?
The new requirements may result in a decreased number of exam candidates in the short term. However, the reason for making these changes is to increase the value of IBCLC certification. The IBLCE vision for the IBCLC credential is to "increase the number and improve the quality of IBCLCs."

IBLCE is the global authority in lactation consultant certification and raising the educational standards for the lactation consultant profession is crucial to the future growth and value of the IBCLC credential. While there may be a short-term drop in the number of prospective IBCLCs, the increased value of the credential will make IBCLC certification more highly desired by not only first-time candidates but also by recertifying IBCLCs.

But what’s not really acknowledged here is that a profession that was already fairly inaccessible without great financial privilege will now be almost totally inaccessible. A lot of IBCLCs have said to me, "Oh, we're so glad to see you! We see so much gray hair at LC conferences, we need young people in the profession!" But young people can't afford to go into the profession, to say nothing of other groups that may have greater financial and family struggles. I go to LC conferences and see almost all white faces. IBLCE acknowledges that fewer people may sit the exam under the new requirements, and they promise a future pay-off. But how far into the future?

So that's what I'm thinking right now. And one final slight tangent: the other thing that writing this post has made me realize really bothers me is the current requirement for practice hours for clinical professionals. I think the need for all this RN-like training especially digs at some people because those who come through non-clinical pathways train for hundreds - and, under previous pathways, sometimes thousands - of hours under experienced LCs (and paid for those hours). However, RNs get to count up hours they spend as part of their jobs - no LC supervision necessary - and then take the exam. I’m not saying this experience is not valuable, but we don’t say to nurses “Hey, you do a lot of things that are related to what doctors do – pass the medical boards and you can practice medicine!” And IBCLCs spend a lot of time talking through anxieties and emotions with their clients, but can’t just count up those hours, take an exam, and become licensed as therapists.

Let me clarify here that I am NOT saying that all, or even most, RN IBCLCs are unqualified! I have gotten my training almost exclusively from RN IBCLCs who I respect profoundly and are fantastic LCs. Several of them have, however, told me how lucky I am to be able to mentor with LCs because when they got their certification they had never worked with another LC and had to learn on their own a lot of what they're teaching me now. To my mind, if non-clinical professionals are now being asked to spend time and money getting the coursework that the clinical people already have, the clinical professionals should be required to spend the time and money on finding and using direct LC mentorship. I think that would be at least as big a step towards improving the quality of the profession as these new requirements.

And that's my more-than-two-cents! Other thoughts out there? Especially from prospective IBCLCs?

Tips on studying for the IBCLC exam

I wrote down all my studying methods and resources just after I took the LC exam, but was superstitiously unwilling to post anything until I knew I passed. (Plus, who knew if it was good study advice or not??)

It's now a long time since I found out that I had passed, but I'm trying to work through my backlog of half-finished posts and realized that this one has just been sitting forgotten for months! I did my best to finish it up with what I still remember about my studying. So if you're preparing for the IBCLC exam, here are my study suggestions...

Edit, 2018: The rest of this post, freshly updated, is now here on a new blog I'm contributing to. Please click through to read the rest!

IBCLC exam over!

DONE!! It was so hard to get to sleep the night before last. I kept thinking "I just wish I could take the test RIGHT NOW and get it over with." I woke up at 5 am and couldn't get back to sleep (which beats my classmate who woke up at 4 am and a study partner who claimed she didn't sleep all night). But once we were at the test center, in line waiting to show our IDs to register for the test, I wanted to slow down and let it all sink in for a moment. My dream, getting to sit for the IBCLC exam, coming true - it's still a little hard to believe.

Now it's all over but the waiting...for the results. I understand in principle why it takes IBLCE sooo long to get the test results back to us. But the end of October? In practice, this is very hard. (It's obviously payback for all my whining and moaning about the GRE being on a computer, and set up so you couldn't skip questions you weren't sure about and go back to them later. While I am VERY glad I could go back on the IBCLC exam - I think I went through both morning and afternoon test booklets at least 3 times each re-reading every question - I have to admit it was pretty nice to get the GRE results instantly.)

And while I think I did reasonably well on the exam, it's so easy to doubt. What if I fail it by a question? What if all the questions I challenged were the ones I got RIGHT? What am I going to tell people November 1st if I fail? I pingpong back and forth between guarded optimism and the prospect of having to actually admit to people that it didn't turn out the way I'd hoped. If you all could do me a favor and forget that I ever took this exam, and not ever ask me about it again, just in case - thanks!

LC Exam minus 3

ACOG lessens (kinda) restrictions on VBACS, stories are written on shackling during labor, and posts are written on the delicate balance to strike when calling out misinformation in "failed" lactation stores, and I don't have time to write about any of it because am studying for the IBCLC exam which is happening! on! Monday!

I am anxious. I am taking practice tests and reviewing flashcards. I am reviewing chapters on immunology and jaundice and developmental milestones. I am arguing with the answers on the practice tests. I am carpooling to the exam with some other test-takers and we have already plotted out our route to avoid the main highway because what if a tractor-trailer jackknifes and we are stuck in traffic and OMFG WE MISS THE TEST. As you can see, I am ready for this to be done!

So if you see me posting on this blog or anyone else's in the next few days, tell me to go back to studying! And in the meantime click the links above for some awesomeness...

My final LC class exam

Our LC class met for the last time the day before graduation. It was sad as such a big percentage of people were getting ready to leave. We'll be taking the exam in July spread out across the country.

While said real exam is coming up frighteningly quickly, we had to do a bit of a pro forma exam at the end of class to make it all official. We wrote it out by hand (ouch! I haven't done much sustained fast handwriting since middle school, and after just a page and a half my hand started to cramp) and then the professor asked us to type it up. I was looking it over today, and I thought I would post my answers here as a little piece of reflection on my LC training this past year:

Question #1: What is the most important things you learned as an LC candidate?

That you can't learn everything you need to know to be a great LC in one year - or maybe not even two or three - and that you don't need to become a great LC before you sit the exam. You have to keep asking questions and learning, and believing that you don't know everything!


Question #2: What are 3 very specific things you'll do as an LC based on your answer to #1?

1) Not to be afraid to admit when I have reached the end of my skills and need help
2) Have more experienced LCs on speed dial
3) Continue educating myself and observing with different people when possible


Question #3: Make up an exam question based on this learning
(Note: We were supposed to try to format the answers just like the LC exam: two wrong answers, one "distractor" that is almost right, and one correct answer. We all complained we could have written a much better question given more time! I'll reproduce my original response faithfully here anyway.)

You have been working with a mother and baby for several weeks attempting to improve the baby's sucking skills, but there has been little change despite using all the techniques you have learned. Your next step should be:
a) Counsel the mother that there is likely nothing that can be done to improve her baby's suck
b) Plan to attend a training on sucking skills
c) Refer the mother to another LC or other specialist with more advanced knowledge
d) Suggest to the mother that she switch to bottle feeding expressed milk and give her baby time to mature before attempting breastfeeding again


This really does reflect a very important piece that I learned this year. I had visions of emerging from training ready to independently help the premature baby with cleft lip and oral aversion whose mother has a low milk supply. And they would be successful, too! At times I got impatient with training: how was I going to learn all this advanced stuff if we didn't move faster? Now I appreciate better that few, if any, LCs are ready to tackle the most advanced stuff when they become certified - at least not independently. More than one LC whom I respect has told me that she became as skilled as she is by admitting when she didn't know what to do next, finding someone who did, and learning from them as they helped that mom.

Back when I did tae kwon do, everyone emphasized that getting your black belt wasn't the end of your training: it was like starting all over again. Well, I start working nights at the hospital this week doing lactation support, and I'm ready to start all over again! This is going to be (I hope) a whole new learning experience.

Public Health Doula, MPH

Family and friends and celebrations have come and gone, graduation is over, and I can now say that I officially have a Master's of Public Health!

To be honest, it feels a bit anti-climactic - my last semester was busy, but mostly with things besides academic work, particularly once my thesis was done at the beginning of April. Unlike the end of my undergrad degree, which was a relieved crossing-the-finish-line feeling, my graduate commencement was more of a "oh, hi finish line, I knew you'd be around here somewhere" feeling.

Still, I am happy and proud of my shiny new graduate degree, and I'm hoping to put it to good use in the near future...whatever form that takes. In the meantime, I want to take a moment to appreciate how much writing this blog, and reading/connecting with other blogs has been an amazing education in and of itself over the past two years. It's filled in some of the spaces a public health education doesn't address, when it comes to my own particular interests. I've learned how to monitor the heck out of a program in my MPH education, but I didn't have many opportunities to debate the nature of informed consent, hear stories from women who felt judged for formula feeding, or gauge how public health recommendations look to, and are interpreted by, the outside world.

I've also valued the opportunity to connect with like-minded people around the country and around the world. The issues of sex, reproduction, reproductive health, abortion, pregnancy, birth, breastfeeding, our agency as women over our own bodies...these are complex issues with many layers of thinking and learning to work through as we talk about them. Sometimes it feels frustrating to feel like you're starting over at "101" level every time you try to discuss them with someone new. I have been so lucky to find people who are already thinking about these issues and their interconnections, and can not just meet me where I'm at but push me further.

It's also deeply enriched my doula practice. I learn about new topics, techniques, research, and ways of thinking about and conveying information to others. More and more frequently, I find myself referring clients and friends to blogs and to blog posts for questions like understanding rising c-section rates or writing a birth plan. Sometimes I think the blog world should be required reading for new doulas (and other birth professionals!) It expands my worldview beyond what I just learn/hear in my training or from other people locally, and helps me contextualize doula practice in the bigger picture of birth issues and activism.

Finally, I have loved building a small but growing community of readers for my blog. Posting about wondering where to find doula clients and having so many wonderful and generous suggestions was such a help for me, and a boost to my confidence. I am so grateful to all of you who commented on that post, and to all of the readers and commenters out there!

I'm not sure what's next for me as a doula and a newly-minted MPH, but I'm excited to be starting work half-time next week at the hospital where I've been training to be an LC. They are hiring me temporarily as a "breastfeeding specialist" (since I'm not an LC yet), to do several night shifts of lactation support a week. This will be my first experience doing lactation support in the hospital solo, not to mention my first experience working nights (well, I've stayed up many nights as a doula but this seems a bit different!) I am excited and of course at least a little nervous, and interested to see where this leads.

I'm also not sure what's next for this blog - between graduation and traveling, it seems to be that just like last year, May has been a vacation month from blogging! And while it always seems like there are a dozen posts or news items a day popping up in my blog reader or news alerts that I could link to and talk about, it's seemed harder recently to actually get those into the blog. With a shift in my work and to some extent my focus, my posts may change too - more? less? different topics? We'll see!

I do plan to do a post soon on applying to and choosing an MPH program, since I have had several e-mails about that from readers and I would really like to help people understand more about the degree, what it can do for you, and what you should be thinking about when applying. As always, I am open to other requests for topics! Just comment, or e-mail, and let me know.

In the meantime, I hope you'll keep reading, and commenting, and linking, and e-mailing! Every time I check my subscriber stats, I do a little happy dance that more people are interested in what I have to say (because as anyone who knows me will tell you, I love to talk) and I hope that community keeps growing.

True story

Our LC training is in a hospital-based conference center with various workshops going on in other rooms. Yesterday, right across the hall from us? A "Nestle Infant Nutrition" workshop.

Great new blogs, and a minor LC update

You can take a look at my blogroll (greatly in need of updating) for many of the blogs I love. But I thought I'd highlight a few new (or new-to-me) that I've been enjoying:

First the Egg is not exactly new, as it's a expanded reincarnation of Feminist Childbirth Studies, but it's new enough! It's not just a blog but also a "nonsexist space for people who want to learn, reflect, commiserate, or laugh about being pregnant, giving birth, and helping children grow up whole and happy." There are feminist resources on pregnancy & birth (including breastfeeding), parenting, and women's health.

A Midwifery Journey is the blog of a nursing student who has been applying to CNM programs. She blogged a bunch about her impressions of various schools and opportunities, and has recently decided on Yale. It's been an educational and helpful read for me, given my constant personal swirling vortex of thoughts about the future ("midwife? yes? no? yes? no?" would be a short version, maybe someday I'll post the long version). I'm looking forward to hearing more about her experiences!

The Academy of Breastfeeding Medicine's new blog is great! With posts on the science, medicine, and policy of breastfeeding, this is quickly becoming a new favorite for me. Check out the post on how to critically evaluate media reports of breastfeeding studies, and the studies themselves.

That's all for today! I have a training all day, every day this week for my LC course. It's a review workshop for people interested in lactation support/planning to be LCs/planning to sit the exam. It's a mix of good, interesting stuff and a little more boring, less useful stuff, as is almost every workshop and/or conference. It does feel like a very solid review of everything we've learned this year which is both good and bad: good to review everything and get it compressed into one place in our heads (and notebooks) before the exam. Bad (or at least less good) not to be learning so much new stuff. We were talking in the car on the way back about how since we're the first class to go through this LC training, we're the guinea pigs for things like our textbook (there will be a different one used next year) and this review course (TBD if they require it again next year). The disadvantage is, of course, being guinea pigs for the things that don't work; but considering the plans to expand the training next year, I feel so lucky to have been a member of this first small class. The close relationships we've been able to forge with each other and with our precepting LCs have been so wonderful. And even when I'm getting bored in the workshop, I sit there and remind myself how incredibly lucky I am to have gotten the chance to do the training this year. I just cross my fingers that I can find a way to keep doing clinical, hands-on work with breastfeeding dyads. It is one of my favorite things in the world to do!

Fun fact of the day

Jimmy Carter was the first U.S. president born in a hospital.

That's all I can muster for today! I am doing five days of LC training at the hospital this week and it is, while incredibly fun and educational, surprisingly (for me) draining on both mind and body. After this week is over, and I finish my master's paper, I hope I can get back to posting more. But in the meantime, I thought I would share about Jimmy Carter!