On Credentials: Discerning and Differentiating Between Those That Are Similar Yet Different

From a cognitive science point of view, discerning and differentiating between things that are similar yet different is cognitively demanding, and these cognitive demands range from mild to moderate to pronounced. 

We can quickly relate to this in our field of infant feeding when we observe the common difficulties that so many infants display when task-switching between the breast and a learning experience with an artificial nipple, particularly during early learning but not only during early learning. Similarly, families as well as hospital nursery staff often report that bottle-fed babies frequently "do better" with one style of artificial nipple versus another, and such observations are also made when infants are given different styles of soothers/pacifiers. We can expect the older baby as well as the toddler to reject one style of sippee-cup in favor of another, rather than task-switching between the two different styles with ease.   

In addition to the cognitive demands in learning motor skills, other forms of learning are often cognitively demanding from a task-switching perspective, including language. In our field of infant learning for milk-feeding skills, we are rightly concerned that the general public will have cognitive demands in discerning and differentiating between similar but different credentials of the infant feeding specialist. In these examples of job titles from our own field as well as other fields, consider the cognitive demands in learning how to accurately differentiate these professional titles, either with little difficulty, moderate difficulty, or marked difficulty: 

Teacher versus Teacher's Aide

Manager vs. Assistant Manager

Nurse vs. Nursing Assistant

Licensed Practical Nurse (LPN) vs. Registered Nurse (RN) vs. Nurse Practitioner (NP) 

Doctor/physician vs. Physician's Assistant

Optician vs. Optometrist vs. Ophthalmologist

International Board Certified Lactation Consultant vs. Certified Lactation Specialist vs. Certified Breastfeeding Specialist vs. Certified Lactation Counselor vs. Certified Lactation Educator Counselor vs. Breastfeeding Counselor vs. Breastfeeding Peer Counselor vs. Lactation Educator vs. Certified Lactation Educator vs. Community Breastfeeding Educator vs. Certified Clinical Lactationist, and so on.   

We clinicians are often asked by new parents about the differences between breastpumps, and we are educated and trained to teach these differences in pump technology, in order that parents may be best educated to discern which pump will meet their needs. In the U.S., prenatal breastfeeding classes typically include a segment on various pumps, with detailed instruction in how one type of pump varies from another, and such teaching is also provided at the hospital bedside and in home settings.

The eminent psychologist, William James (1842 - 1910), discussed the cognitive challenges in discernment and differentiation, using the examples of discerning between different red wines, and differentiating one twin from another. The cognitive demands of task-switching (and the subsequent switch costs of decreased speed and accuracy for the task) have been heavily studied in the cognitive sciences for decades, and these areas continue to be heavily studied. Today's PubMed search using the term "task switching" yielded 2,873 results. 

The extraordinary growth of the lactation consulting profession has been nurtured and supported by the credentialing body, the International Board of Lactation Consultant Examiners (IBLCE).  For decades, this credentialing body has promoted the International Board Certified Lactation Consultant (IBCLC) as "The Gold Standard" in specialized knowledge and clinical expertise in breastfeeding and human lactation. 

IBLCE offered the first board certification exam in 1986, and since that time, the lactation consulting profession has grown to over 28,000 IBCLCs from 105 countries, with over 15,000 IBCLCs in the United States alone.  In the short timespan of the profession's 31-year history, the dramatic growth in the number of IBCLCs is a remarkable testament to the care of the dyad by skilled clinicians.  The growth of our profession is also a testament to the decades of support from the IBLCE in promoting the education and training of the IBCLC as "The Gold Standard" in caring for the dyad. 

Parents who seek skilled infant feeding and lactation care are best served by appropriately credentialed clinicians. As parents seek information about various credentials for lactation and infant feeding specialists, this search should not be so cognitively demanding as to require the expenditure of hours by sleep-deprived new parents.  When parents can readily access concise information about the credentialing of lactation clinicians, parents should then be able to accurately discern and differentiate one credential from another, in order to meet their own health care needs and the health care needs of their infant.