Ms Megan Etherton:

Ms Cahill and Ms Rea spoke to this earlier in regard to establishing competencies and being able to measure them and ensure there is continuing professional development for everyone within a hospital setting who comes into contact with a woman who is attempting to breastfeed. We are not competent to make a decision on what those levels should be but the 2015 competence framework sets out three levels, namely, awareness, generalist and specialist competencies, within the area of lactation consultancy or lactation support in the hospital. The intention, as set out by the HSE at a recent meeting we had with its representatives, is that that role of lactation consultant should operate at that higher level of specialty, offer in-depth care to people with complex challenges and provide education and support to other staff within the hospital setting.

I guess it is a trickle down mode of education in that a mother might present with a challenge, the lactation consultant is called and then that midwife learns how to deal with that challenge for the next time. We would see that the two main issues. There are obviously the ongoing education and establishing international board certified lactation consultants, IBCLCs, with specialist skills in the roles and having enough of those lactation consultant roles and having appropriate staffing of midwives within the hospital. They may have the skills and knowledge already but they do not have the time to transmit it. What will change in the future if they have the skills and knowledge and they still do not have time to transmit it and to sit down with a woman? I am not sure that fully answers the question.