The us versus them of IBCLCs and CLCs has been going on for years. I admit that I felt the same way many IBCLCs do about CLCs too. It is hard to see someone take a one week course and see themselves as equal, but I also don’t feel that is how most CLCs are. All lactation care providers have been continuously undervalued in healthcare and not given credit for their expertise. Not all breastfeeding dyads need the level of care an IBCLC can and does provide though. Many families simply need encouragement and education about the normal course of breastfeeding, including normal newborn behavior, which CLCs are well equipped to provide and should be providing. Even minor corrections in positioning and latch are well within the scope of a CLC. After careful consideration, and heated conversations (thank you to my friend and ally Lissa for challenging me to look at this issue through a health equity lens), I believe that the biggest issue in the minds of many IBCLCs is that there is no current place for CLCs in our healthcare system in regard to the currently used Current Procedural Terminology (CPT) codes and billing. I believe CLCs do have a place in our healthcare system, and I believe I have a solution.
CLCs are counselors, they are well equipped for counseling and should be reimbursed. CLCs know normal and know to refer when things are not normal. As IBCLCs we should embrace this and network with our community CLCs and support them.
The rest of this discussion gets in to some of the nitty gritty of billing and coding, which while not fun is part of this solution. So try to stay with me! I know when I starting looking at all of these codes and terms when I first started I felt like my head was going to explode!