News article

UMass Memorial cuts lactation staff

November 11, 2011

Worcester, MA– UMass Memorial Medical is elminating all of its nurse-IBCLCs, effective Dec 1, in favor of fewer IBCLCs and more lesser-trained personnel. For more details, please read the original letter sent by the Massachusetts Breastfeeding Coalition to UMass Memorial Medical or read the text of the letter below.

November 10, 2011

Mr. John O’Brien
President and CEO
UMass Memorial Health Care (System Administration)
Biotech One, 365 Plantation Street
Worcester, MA 01605

Dear Mr. O’Brien,

It has come to our attention that UMass Memorial has eliminated all of its RN-Lactation Consultant positions, and plans to outsource its inpatient lactation consultants with lesser-trained staff provided by an outside company, Lactation Services, LLC. We understand that most of these new personnel carry only the credential of Certified Lactation Counselor (CLC), and are not International Board Certified Lactation Consultants (IBCLCs). Further, it is our understanding that none of these personnel are RNs. We understand from CME/Invacare that you will have 56 hours a week of an IBCLC (1.4 FTE), half of which is dedicated to the NICU, and there will be CLCs to provide other post-partum help. CME/Invacare tells us that “any mother who requires a lactation consult is referred to the IBCLC.”

We appreciate the need to cut costs in these difficult economic times. However, there are multiple reasons why this decision is not in the best interest of UMass Memorial or its patients:

1. IBCLCs and CLCs do not have equivalent training and experience. IBCLCs require many times the training hours that the CLC requires. In addition, the IBCLC credential also requires hundreds of hours of hands-on training, whereas the CLC training is limited to a single 5 day course.
2. The Association of Women’s Health and Neonatal Nurses (AWHONN) and the US Lactation Consultant Association (USLCA) have issued staffing guidelines for inpatient lactation consultants, both of which are limited to those with the IBCLC credential.
3. For UMass Memorial, the above staffing recommendation would be 1.9 full-time equivalent IBCLCs per every 1,000 births. This would total 5.4 FTE IBCLCs for UMass Memorial, assuming about 3,700 births. Thus, the planned a 1.4 FTE IBCLC will fall far short of what is necessary to serve your number of patients.
4. The Department of Public Health perinatal regulations state that any mother who requires “advanced lactation care” must be seen by an IBCLC or someone with “equivalent training and experience.” As noted above, the CLCs cannot provide advanced lactation care, and there are not enough IBCLCs planned who can fulfill this role.
5. The Centers for Disease Control and Prevention and the Surgeon General both recognize the IBCLC as the standard of care for qualified lactation consultation.
6. Lactation consultants are currently not licensed in any state, so hiring non-RN lactation consultants would mean there is no government oversight or consumer protection for these individuals providing clinical care at your hospital.
7. It is standard of care for hospitals to provide RN-IBCLCs, especially those of equivalent size as UMass Memorial, with a level 3 nursery. Whoever will fulfill the role in the NICU should have experience and training in caring for critically ill preterm infants. By assigning this care to non-licensed personnel without a nursing background is risky for the infant, the mother, and for your institution.

Patients at UMass Memorial deserve evidence-based maternity care practices that follow acceptable national standards of care. Thank you for your consideration.

Sincerely,

Melissa C. Bartick, MD, MSc
President, Massachusetts Breastfeeding Coalition

cc: Nancy Brennan, Manager of Maternity Services, UMass Memorial Medical Center
Karin Downs, Massachusetts Department of Public Health
Anne Dematteis, Massachusetts Department of Public Health