Appendix e entry Level Competencies



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APPENDIX E – Entry Level Competencies
For each of the following general education content and lactation competencies, list the courses in which each one is taught.





Required content/competency

Course in which content/competency is taught

GE

General Education




1

Biology: Growth, structure and function of living organisms.

     

2

Research: Fundamental theories and concepts of scientific inquiry and evidence-based practice.

     

3

Human anatomy: Structure of human body systems.

     

4

Human physiology: Physiology and function of human organ systems.

     

5

Child development: Developmental stages for infants and young children

     

6

Basic nutrition: Principles of nutrition and health

     

7

Psychology: Foundations of psychology, counseling or interpersonal communication

     

8

Sociology: Sociological concepts of the cultural aspects of human behavior

     

9

Health care profession: Medical documentation, health/medical terminology, ethics for health professionals (ethical conduct, confidentiality, informed consent and conflict of interest).

     

10

Health safety: Occupational safety, universal safety precautions, infection control, basic life support.

     

A

Communication and Counseling




1

Obtain the parents' permission to provide care to their infant/child

     

2

Utilize appropriate counseling skills and techniques

     

3

Respect a person’s race, creed, religion, sexual orientation/gender identity/gender expression, age, and national origin

     

4

Integrate cultural, psychosocial and nutritional aspects of breastfeeding

     

5

Ascertain parents' goals for breastfeeding

     

6

Utilize effective counseling and communication skills when interacting with parents, children, their families and other healthcare providers

     

7

Provide support and encouragement to enable parents to successfully meet their breastfeeding goals

     

8

Apply the principles of family-centered care while maintaining a collaborative, supportive relationship with breastfeeding families

     

9

Describe gender issues within a culture as they relate to breastfeeding

     

10

Utilize adult education principles

     

11

Select appropriate teaching aids

     

12

Provide information at a level which parents can easily understand

     

13

Provide support and information to parents to make evidence-informed decisions

     

14

Provide evidence-based information regarding use of medications (over-the-counter and prescription), alcohol, tobacco and street drugs, including their potential impact on milk production and child safety

     

15

Provide evidence-based information regarding complementary therapies during lactation and their impact on milk production and the effect on the infant/child

     

16

Provide anticipatory guidance to reduce potential risks to breastfeeding parents or their infant/child

     

17

Counsel and support the family in coping with the death of a child

     

18

Make appropriate referrals to other healthcare providers and community support resources in a timely manner depending on the urgency of the situation

     

19

Provide information on community resources for breastfeeding assistance

     

20

Assess social supports and possible challenges

     

21

Provide follow-up services as required and requested

     

22

Counsel and support donations to milk banks

     

B

Documentation and Communication




1

Work collaboratively with the healthcare team to provide coordinated services to families

     

2

Obtain parental consent for obtaining and disclosing of information as needed or as specified by local jurisdiction

     

3

Maintain documentation of all contacts, assessments, feeding plans, recommendations and evaluations of care and retain records for the time specified by the local jurisdiction

     

4

Provide written assessments as required

     

5

Respect the privacy, dignity and confidentiality of families except where the reporting of a danger to a parent or infant/child is specifically required by law

     

C

History Taking and Assessment




1

Obtain a lactation history

     

2

Identify events that occurred during the pregnancy, labor and birth that may adversely affect breastfeeding

     

3

Assess physical, mental and psychological states

     

4

Assess the breasts to determine if changes are consistent with adequate function in lactation

     

5

Assess for normal child behavior and developmental milestones

     

6

Assess and determine strategies to initiate and continue breastfeeding when challenging situations exist/occur

     

7

Identify correct latch and attachment

     

8

Assess effective milk transfer

     

9

Assess for adequate milk intake of the infant/child

     

10

Address inadequate milk intake

     

11

Assess infant oral anatomy

     

12

Assess normal neurological responses and reflexes

     

13

Provide information regarding increasing or decreasing milk volume as needed

     

14

Assess milk supply

     

D

Prenatal and Perinatal Breastfeeding Support




1

Teach a prenatal breastfeeding class

     

2

Perform a prenatal breast assessment

     

3

Address health related life style issues, including alcohol, tobacco and drugs

     

4

Assess and counsel parents on nutrition

     

5

Support labor and birth practices that optimize breastfeeding outcomes

     

6

Identify and promote positive breastfeeding practices

     

7

Promote continuous skin-to-skin contact of the newborn and caregiver

     

8

Discuss the appropriate continuation of breastfeeding when parents and their infant/child are separated

     

9

Provide education to assist the family to identify newborn feeding cues and behavioral states

     

10

Educate families on normal child behaviors indicating breastfeeding needs; signs of readiness to feed, and expected feeding patterns

     

11

Assist parents and their infant/child to find comfortable positions for breastfeeding

     

12

Provide suggestions as to when and how to stimulate a sleepy baby to feed

     

13

Provide education for the family regarding the use of pacifiers/ dummies including the possible risks to lactation

     

14

Provide information and strategies to prevent and resolve sore damaged nipples

     

15

Provide information and strategies to prevent and resolve engorgement, blocked ducts and mastitis

     

16

Provide appropriate education for the family regarding the importance of exclusive breastfeeding to the health of the parent and infant/child and the risk of using human milk substitutes

     

E

Extended Breastfeeding Support




1

Teach appropriate food selection for breastfed children

     

2

Provide information and strategies to minimize the risk of Sudden Infant Death Syndrome (SIDS) or Sudden Unexplained Death of an Infant (SUDI)

     

3

Provide information regarding family planning methods including Lactation Amenorrhea Method (LAM) and their impact on lactation

     

4

Assist parents with their child’s teething and biting as it impacts on breastfeeding

     

5

Identify issues related to early weaning and appropriate interventions/teaching for the family

     

6

Provide information regarding weaning from the breast when appropriate, including care of the breasts and preparation and use of human milk substitutes

     

7

Provide instruction and guidance on toddler breastfeeding

     

8

Describe and teach approaches to breastfeeding while pregnant and tandem nursing

     

F

Problem-Solving




1

Evaluate potential and existing factors impacting a parent’s breastfeeding goals

     

2

Assist and support parents to develop, implement and evaluate an appropriate, acceptable and achievable breastfeeding plan utilizing all resources available

     

3

Evaluate parents' understanding of all information and education provided

     

4

Provide evidence-based information to parents regarding the use of techniques and devices

     

5

Evaluate and critique how techniques and devices may be used to ensure initiation and/or continuation of breastfeeding in certain circumstances

     

6

Critique and evaluate indications, contraindications and use of techniques, appliances and devices which support breastfeeding

     

7

Evaluate, critique and demonstrate the use of techniques and devices which support breastfeeding, understand that some devices may be marketed without evidence to support their usefulness and may be harmful to the continuation of breastfeeding

     

8

Carefully choose a method of feeding when supplementation is unavoidable and use strategies to maintain breastfeeding to meet the parent’s goal

     

G

Infant/Child Breastfeeding Challenges




1

Develop and apply a plan of action to assist the breastfeeding dyad that has undergone a traumatic birth

     

2

Develop and apply a plan of care for the breastfeeding parent with a preterm or late preterm infant

     

3

Design and implement a plan of care for the parent with a newborn that is small for gestational age (SGA) or large for gestational age (LGA)

     

4

Design and implement a plan of care for breastfeeding multiples

     

5

Facilitate breastfeeding for the medically fragile and physically compromised infant/child

     

6

Describe and implement a plan of care for the breastfed hypoglycemic newborn

     

7

Calculate an infant/child’s caloric/Kilojoule and volume requirements

     

8

Assess the breastfeeding infant/child’s growth using World Health Organization adapted growth charts

     

9

Assess and implement a breastfeeding plan for the hyperbilirubinemic newborn

     

10

Identify infant/child conditions that may impact breastfeeding, including but not limited to disorganized or ineffective suck, ankyloglossia, cleft lip/palate, Pierre Robin syndrome, and Down syndrome

     

11

Identify yeast infection and instruct the parent on appropriate interventions

     

12

Assess the infant/child for colic, gastric reflux, lactose overload, and food intolerances and their impact on breastfeeding  

     

13

Assist parents of an infant/child with a chronic medical condition that may impact breastfeeding

     

14

Recognize and offer breastfeeding assistance for the infant/child with cardiac problems

     

H

Maternal Breastfeeding Challenges




1

Identify medical conditions that impact breastfeeding and appropriate teaching for parents

     

2

Identify special needs of adolescent breastfeeding parents

     

3

Assist and support the parents to identify strategies to cope with peripartum mood disorders (prenatal depression, “baby blues”, postpartum depression, anxiety and psychosis) and access community resources

     

4

Support parents who are inducing lactation or relactating

     

5

Address physical disabilities which may limit parents' handling of their infant/child

     

6

Counsel and support HIV positive parents and those of unknown HIV status, and be able to convey current recommendations on infant feeding

     

I

Public Health




1

Teach the use of breastfeeding during emergencies and appropriate support

     

2

Utilize quality assurance standards in delivery of care

     

3

Develop a community outreach program

     

4

Describe national and global policy and program development, history, rationale and current issues

     

J

Research, Legislation and Policy




1

Critique, evaluate and incorporate evidence-informed findings into practice within the laws of the work setting

     

2

Evaluate research and breastfeeding data

     

3

Describe various research methods and the most appropriate method for a given research question

     

4

Use appropriate resources for research to provide information to the healthcare team on conditions, modalities, and medications that affect breastfeeding and lactation

     

5

Describe and apply behavior change theories

     

6

Participate in the development of policies at global, national, and local levels which protect, promote and support breastfeeding

     

K

Professional Responsibilities and Practice




1

Conduct oneself in a professional manner, practicing within the framework defined by the IBLCE Code of Ethics, the Scope of Practice for the IBCLC, and the Clinical Competencies for the IBCLC’s Practice

     

2

Assist families with decisions regarding feeding their infants/children by providing evidence-based information that is free of any conflicts of interest

     

3

Advocate for breastfeeding women, infants, children and families in all settings and promote breastfeeding as the infant/child feeding norm globally

     

4

Promote the principles of the WHO Global Strategy for Infant and Young Child Feeding

     

5

Promote the principles of the Baby Friendly Hospital Initiative

     

6

Demonstrate the process to report to IBLCE if found guilty of any offence under the criminal code of the IBCLC’s country or jurisdiction in which they work or if sanctioned by another profession

     

7

Demonstrate the process to report to IBLCE any IBCLC who is functioning outside this Scope of Practice for IBCLCs, not maintaining a practice which meets with the IBLCE Code of Ethics or the Clinical Competencies for IBCLC Practice

     

8

Describe and analyze practice setting options for lactation consultants

     

M

Leadership and Teaching




1

Demonstrate personal leadership skills that reflect self-awareness and vision

     

2

Demonstrate leadership and cultural awareness when communicating within an organization and when representing an organization to others

     

3

Provide breastfeeding information to lay and health professional audiences utilizing adult learning methods and demonstrating public speaking skills

     


2016 Lactation Education Accreditation and Approval Review Committee


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