The Gold Standard Line

Feb

Shuffle off to Buffalo …

by Marie

Off I’m gonna shuffle, shuffle off to Buffalo!

My earliest recollection of being in Buffalo was when I was in high school. The National League for Nursing Exam was being given in Buffalo, and I needed to take it. At least, I *think* it was the NLN Exam. Seems like it was some kind of an aptitude test. I distinctly remember it was the coldest day of the year. And, of course, there was snow. (Isn’t there always snow in Buffalo?)

My father had driven me as close to the testing site as possible. I was wearing a warm wool coat with a beaver collar (quite THE thing to wear in those days) and knee-high boots. The small part of my legs that wasn’t covered by the coat or the boots was red from the bitter, sub-zero cold. Buffalo is cold.

Tonight, it’s a fairly decent night in Buffalo. Cold, but not bitterly cold. Windy–quite windy–but tolerable.

And that’s not the only difference. Now I’m a real nurse, offering a real course. And I’m a nurse with white hair! So much time has passed.

Some days, though, I wake up and wonder if I’m really a nurse. How did I ever get to be a nurse? How did I ever get into nursing school? How did I ever pass the boards….on the first try, at that! To me, becoming a nurse was always just a little far out of my reach. But somehow, I was able to reach that goal.

So here I am. I’ve shuffled off to Buffalo to present my Comprehensive Lactation Course, starting tomorrow. I was finished for the 2011 season; this is an encore performance. I feel truly lucky to be asked to present in Buffalo at Catholic Health System.

“Off we’re gonna shuffle, shuffle uffle uffle uffle, shuffle off to Buffalo.” (Song lyrics by Don Bestor.)

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Categories: IBCLC Prep

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Feb

Paperwork and the IBLCE Exam 2012

by Marie

For everyone who took my course in the fall — or who plans to take my course in the spring — I can finally answer what might be your most pressing question: What paperwork must be completed before taking the IBLCE exam?

If you are taking the exam in English in the United States this July … if this is your first time taking the IBLCE exam … and if you are following Pathway 1, keep reading. (Nearly all of my course participants follow Pathway 1. If you are on a different pathway, I can still help you, but this blog post isn’t for you.)

Here are the documents that I believe you need to download, comprehend, and complete:

Candidate Information Guide 2012: This was published within the past month, and addresses: what IBLCE is, where and how to find and contact IBLCE, important IBLCE publications, overview of eligibility requirements, and the different pathways. It also provides a pathway checklist and other information specific to the exam itself. I advise everyone to read this thing, cover to cover.
Exam CandidateSupplement: This addresses key dates in 2012, exam fees, and issues related to applying for the exam (such as site locations, exam language, and more.)
Pathway 1 Report: This document is absolutely critical for you to have and complete, as this ”report” is really your report to them, not the other way around as you might expect. The form substantiates how you have fulfilled your eligibility to use Pathway 1 to sit for the exam. While you’re at it, visit this page, which is all about applying for the exam as a Pathway 1 candidate.
Exam Application and Deadlines and Fees: Well, as you can imagine, this is the money piece! The paperwork is never done until the money changes hands! Note: This link is to the online application.
Exam Payment Forms for Canada and the United States: Again, this list is for “my people” so I’m assuming that if you’re read this far, you need the forms for the US or Canada. When you download the form, be certain that you have the right one.

If you want to sit for the exam in July of 2012–just over 5 short months away–it is to your advantage to get all of this paperwork completed and submitted to IBLCE now, before the end of February. You can submit it later, but you’ll be charged extra by IBLCE if you delay. However, you must have all of your paperwork done, so start working on it today!

Those of you who sat for my 90-credit course recently should be in great shape, as long as your clinical hours are in order. If you took my 60-credit course in 2010, call my office right away; we can fix you up with some extra credits! If you took my 45-credit hour course in 2009, definitely call my office immediately! You could still sit for the July exam if you really hunker down.

OK, folks, that’s all. Please call my office at 703-787-9894 or e-mail us at info@breastfeedingooutlook.com if you need additional help, so you’ll be all ready to take the exam on Monday, July 30.

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Categories: IBLCE Exam

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Jan

Will You Certify (or Recertify) in the Year Ahead?

by Marie

IBLCE has announced that it is going green this month with the launch of an online application process for first-time applicants as well as a new system that will allow those who are already IBCLCs to apply for recertification by exam or by CERPs.

The new Credential Management System (CMS) should make it easier for IBCLCs to track their credits. Looking ahead, you’ll want to be aware of the following costs and deadlines.

2012 Cost and Deadlines:
First Time Taking the Exam
Cost     Deadline
$550   February 28
$660   April 30

Recertifying by Exam
Cost    Deadline
$320   February 28
$470   April 30

Recertifying by CERPs
Cost     Deadline
$320    February 28
$470    July 31

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Categories: IBCLC Prep, IBLCE Exam

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Dec

Critical Info for 2012 IBLCE Exam Candidates

by Marie

If you are NOT a nurse, dietitian/nutritionist, midwife, occupational therapist, physician, or other licensed healthcare professional (i.e., chiropractor, dentist/dental hygienist, pharmacist, psychologist or social worker, physical therapist, physician’s assistant, speech pathologist/therapist) … READ ON.

If you will be taking the IBLCE exam for the first time in 2012 … READ ON. (If you are re-certifying, you’re exempt from the following requirements.)

The IBLCE is now requiring non-healthcare professionals taking the exam for the first time to demonstrate completion of continuing education in six topics:

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

Although I said otherwise during my recent Comprehensive Lactation Course, I have since learned that these requirements must be met IN ADDITION TO the 90-credit course.

If you attended my Comprehensive Lactation Course this fall and are not a licensed healthcare professional, call my office immediately at 703-787-9894. (We will try to reach you, but it is probably
quicker if you take the initiative here.) Do not panic.

You will need to find a basic life support course. The Red Cross and many hospitals offer these courses, or you may consider an online option. As for the other topics, we will make sure that you are covered—at no cost to you—before you apply for the exam.

We’re here to help you succeed. Give us a call.

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Dec

Flying Home After the Last Course This Year

by Marie

Planning, writing material for, and teaching a 90-credit course was one of the more difficult things I’ve done in a long time. Like most difficult things, I probably wouldn’t have attempted it if I had known how really difficult it would be! Now, I’m finished. I’m sitting Gate 14 in the San Diego airport, waiting for the flight to Washington DC. The last week or so is a blur in my mind. Many days, many people, many questions, many ideas for revising next year’s course. Anyone who has ever watched me jot notes in my syllabus knows that I’m already preparing for the next year’s course before I finish this year’s course.

The group in San Diego truly helped me to end the season with a bang! The group was very diverse in terms of credentials, experience, clinical setting, and future goals. They also sent me home with several interesting questions and suggestions. I’m working on getting the answers!

I already miss this group, as well as all of you who attended this year’s course in Dallas, Long Island, Baltimore and Denver. Stay tuned to the blog! I’ll answer those questions, as well as others!

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Dec

Danny and the Doctor

by Marie

Truly, the stories that mothers report about their experiences with breastfeeding, doctors, and hospitals never cease to amaze me. Every time I think I’ve heard it all, I hear one that is beyond the beyond. Stay tuned while I tell you what I heard yesterday.

I am in sunny San Diego, teaching my Comprehensive Lactation Course. As we do each year, we offer a scholarship for the course. This year’s scholarship winner, Mary Jo H., told me this story.

When Mary Jo took her newborn to the pediatrician for the first visit, her 18-month old toddler went along. The pediatrician realized that Mary Jo was tandem nursing the newborn and the toddler, and decided to take matters into his own hands. He told the toddler, “Danny, no more breastfeeding. No more breastfeeding for you!” Needless to say, the child was devastated. Luckily, when the pediatrician was out of earshot, Mary Jo reassured her son that he could still have “magels” (Danny’s word for breastfeeding.)

Over the years, I’ve heard many stories of doctors who badger, order, and otherwise intimidate mothers into weaning. But here, the doctor wasn’t picking on the mother! Apparently, he thought that having the conversation with the child would force the mother to wean.

At some point, doctors and other healthcare professionals in the American culture need to realize that breastfeeding is not a medical decision. One might argue that it’s not a nutritional decision, either; human milk certainly provides nutrition and is therefore food, but breastfeeding is more than food. Breastfeeding is a parenting decision. The pediatrician should not decide the time of a kid’s curfew or the age at which a young girl can start dating. Why then, should the pediatrician decide when a baby should stop nursing?

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Nov

Q & A: Kangaroo Mother Care

by Marie

We have a policy [in our hospital NICU] that says we cannot put a baby skin-to-skin (kangaroo mother care) if the baby is born before 28 weeks gestation. Is there any research to support or refute this?
- Erika K., Texas

Hi, Erika! As you are aware, there are dozens of well-controlled trials that show the benefits of kangaroo mother care. The sheer number of studies that show such benefits is astounding. What’s even more remarkable is that to date, no study has shown adverse effects of kangaroo mother care (KMC).

If I were to pick articles that might become seminal pieces, I would pick two whose first author is one of my favorites, Kirsten Nyvquist. (See this and this.) These were apparently written with an eye toward establishing guidelines for KMC. Neither supports the idea of a 28-week barrier, although the authors recognize that some medical conditions may come in the way of KMC, particularly prior to 27 weeks. They nevertheless call on physicians to evaluate each mother-baby dyad case-by-case and hold that KMC is the best practice for all babies after birth. Furthermore, a study by Bohnhorst and colleagues included infants born as early as 24 weeks gestation.

In short, I cannot find any evidence-based reason for your NICU to prohibit all infants born before 28 weeks of gestation from experiencing kangaroo mother care. Although KMC might be inappropriate for a few, it would seem that a case-by-case evaluation would be more appropriate.

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Nov

Last Stop: San Diego

by Marie

The first time I arrived in San Diego, I realized why some people come here and never return. Once again, I am here in one of the country’s most lovely cities. The pace is a little slower than what I experience living outside of Washington DC. The sun is a little brighter. The fruit is a little sweeter. Is it possible that the air is always perfect? I have spent many, many days in San Diego, and it seems to me that it’s always 72 degrees and sunny. Yesterday was the most relaxing day I’ve had in a long, long time.

Yes, we arrived a few days early. I crave the sun and the ocean and the food. Drove up the coast highway and lunch on the patio of a restaurant overlooking the water at Dana Point. I savored the fresh

Mahi Mahi and the gazpacho. I am about to have breakfast outside this morning. It’s gorgeous here.

I’m looking forward to starting my Comprehensive Lactation Course tomorrow. Well, I mean, I am feeling eager to get the course underway–it’s the last course I offer in 2011–but I always long to spend more time sitting outside feeling the warm breezes and eating fresh pineapple and writing. I think better and write better with those tall palm trees fanning me.

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Nov

What People Are Saying …

by Marie

I have been very fortunate to meet a great many wonderful people over the years, at my Lactation Exam Review and Comprehensive Lactation courses. Recently, some agreed to sit down and talk about why they chose the course they did and what they liked about it. See below.

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Categories: IBCLC Prep, IBLCE Exam, Uncategorized

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Nov

Laser Hair Removal and Breastfeeding

by Marie

OK, folks, every time I think I’ve seen or heard it all, I haven’t!

A woman who is now 4 months postpartum is exclusively breastfeeding
her infant son. All is well with mother and baby. She wants to have
laser hair removal for the hairs on her chin. The people at the hair
removal place will not do it until she weans the baby, or until she
provides a written note from her doctor saying that it’s okay to have
the laser treatment!

Hmmmm. I wonder if she should be required to get a note from her
doctor before she sits out in the sun, or blows out the candles on
her birthday cake! Because those two things are just as likely to
cause harm to the breastfeeding baby as the laser treatment!

I think I can explain it like this: Laser hair removal works by a
process called selective photothermolysis. That means that the laser
light is used to heat up and selectively destroy the hair follicles
on the skin. Certainly, the light spectrum can be absorbed by the
hair follicles and also the skin. So holding a match over your chin
would expose your skin to light, too, and the heat could be absorbed
by the skin! The mother who gets a sunburn on her chin (i.e., a
first-degree skin burn) might be uncomfortable, but she is not
endangering her breastfeeding infant! No one would ask a
breastfeeding mother to get a doctor’s permission before she goes out
in the sun. Why then, should laser removal of chin hairs require a
doctor’s permission?

No, there are not any studies on the relationship between laser
removal of chin hair and harm to a breastfeeding infant. Why would
there be? It would be ludicrous, and an incredible waste of money to
conduct such a study!

Several credible sources list contraindications to laser removal of
body hair. Among these are certain antibiotics and other drugs that
can increase skin sensitivity to sunlight and laser light,
hyperpigmentation (including suntan), hypopigmentation and possibly
other skin-related issues. For example, having a suntan may increase
the risk of blistering and pigment change. Breastfeeding is never
mentioned.

Let’s all just try to keep in mind that breastfeeding is a NORMAL
function. In the absence of studies to show that something is safe
during breastfeeding, let’s use some common sense.

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Categories: Public Health

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