Credentials: What Are They and Why Do We Need Them?

What are credentials and why do we need them? Credentials include academic diplomas and degrees, identification documents, certifications, and badges to list a few. Theses credentials give proof of professional qualifications or background. Credentials may also inspire a level of respect. This is important to consider when you are deciding which school to attend or which organization to certify with. For example, when I decided to work toward my BSN (Bachelor of Science in Nursing) I looked for an accredited program – one that was reputable and authorized to educate nurses, one that was known for providing quality education.

These same considerations apply to professional certifications. ICEA began certifying childbirth educators in 1982. This year marks the 45th year that we have set the standard for birth professionals. ICEA has grown and developed programs that include Professional Childbirth Educator, Birth Doula, and Postpartum Doula programs. Our reputation for excellence has been recognized for decades within the communities of medical and birth professionals. Just this year, ICEA was awarded ANCC (American Nurses Credentialing Center) accreditation, meaning that we can now develop and present educational offerings for nursing continuing education.

Today, a variety of organizations offer credentials for childbirth educators and doulas, but few have the reputation for quality that ICEA enjoys. In the same way that hospitals seek accreditation from various agencies, they expect birth professionals to have credentials from organizations that they recognize and respect. ICEA’s longstanding history of family-centered, evidence-based care makes its credentials some of the most widely recognized and accepted – not only in the US, but around the world.  Our international reach continues to expand as we develop relationships with like-minded global partners.

ICEA ensures the quality of our credentials by requiring each candidate to pass an exam at the end of their course of study.  To maintain that quality each credentialed birth professional is required to obtain additional hours of continuing education in order to recertify. As research on best practices for pregnancy, birth, and breastfeeding continue to grow, we want to ensure that the knowledge of birth professionals certified by ICEA is current and evidence-based.

Becoming a credentialed birth professional is costly – in time, effort, and money – but it is worth it! ICEA credentials demonstrate your commitment to birth work. It is a verification of your professionalism, as well as the level and quality of your knowledge.

Recently, ICEA streamlined the membership and certification process. Our management company has worked diligently to make this process as smooth as possible, and we appreciate the ways in which you – the members of ICEA – have embraced this new framework. This tells us that you value what ICEA stands for – family-centered, evidence-based care – and that you value the ICEA credentials. We will continue to work hard to support and educate you as you flourish in supporting and educating childbearing families.

Flourishing for ICEA,

Debra Tolson, ICEA President and Bonita Katz, ICEA President Elect

Doula, Advocate, Activist

Most of us in birth work are well aware of today’s controversies in maternal health care: high cesarean rates, increasing maternal mortality, inadequate informed consent/refusal, lack of personal autonomy, and the list goes on.

These issues concern us – and they should.  We do this work because we care about mothers, babies, and their families.  And doulas are right in the middle of it all.  What is a doula’s role when a woman is in labor and it seems as though her wishes are not being honored? How does a doula advocate for her client?

Before we answer those questions we must remember some facts:

  1. In most instances, the woman chose her care provider and her place of birth. While it is possible to change both of those while she is in labor, that rarely happens.  And who is to say that the next care provider or place of birth will be an improvement? Most of the time you will have to work in the place and with the providers that the woman has already chosen.
  2. The woman is in labor. If a doula chooses to blatantly disagree with the care the woman is receiving she forces the woman into a decision.  Either she must choose her medical care provider over the doula (thus compromising the support the doula could offer) or she must choose the doula over her care provider (and so compromise her relationship with those delivering medical care).

So what can a doula do?  Encourage the mother and her partner to ask questions.  This does two things: First, it validates the soon-to-be parents as adults responsible for their own care and the care of their child.  This is their baby and their birth.  This is a key component of family centered maternity care.  The family makes the decisions that are right for them. Secondly, their questions may be an indication to their care provider that they need to communicate more clearly. Improving communication not only benefits the family, but it also improves customer satisfaction scores for the birth facility.

The doula herself can also ask questions. The recent update on doula care published by Evidence Based Birth (EBB) offers some welcome insight into client advocacy.  Good questions provide a way to ensure that the woman is aware of her options without negating the role of the healthcare provider. To quote the EBB article: “For example, if it looks like the provider is about to perform an episiotomy without the person’s consent: ‘Dr. Smith has scissors in his hand. Do you have any questions about what he is wanting to do with the scissors?’” Questions like this inform the woman (and her partner) and allows them to decide what to do with the information.

Doulas can advocate in this way for their clients, but how do doulas address those major controversies mentioned at the beginning of this blog? We must make a distinction between advocacy and activism.  Both are necessary, but they are approached in very different ways and in different settings.  Advocacy is described above and defined in the EBB article as “supporting the birthing person in their right to make decisions about their own body and baby.” Activism is taking on one or more of the big issues, researching and publishing the facts, and educating the public. Advocacy may take place in a clinical setting while the woman is in labor, but that is not the place for activism. Doulas advocate for one woman at a time.  Activism addresses an issue that affects many women.

Although a doula can be a birth activist, she must realize that activism may close some doors for her.  A birth facility may refuse her access if they do not appreciate her public stand on some issue.  Some have implied that birth workers must be activists in order to make effective change in maternal health care.  Activism will accomplish some change.  But so will the relationships that others build with health care providers.  The fact is that there are many ways to change the system.  We need activists… and we need advocates.  Let’s remember the difference and work within role we have chosen.

Dekker R (2017). Evidence on: Doulas. Evidence Based Birth. Retrieved August 23, 2017 from
Katz B (2017) One doulas difficult dilemma. International Journal of Childbirth Education. 32(3), p. 6.

Annual Membership Meeting Announcement

Notice is hereby given that ICEA will hold its Annual Membership Meeting on Thursday, October 19, 2017, at 1:30 PM ET via conference call. It is free for members to attend.

At this Annual Meeting, members will learn:

  • What the Board of Directors is working on
  • Who the 2018 Board of Directors will be
  • What has been achieved in 2017
  • What to look forward to in 2018

Time will also be given for members to pose questions to the board. Register now to be sent the call-in information. Space is limited to the first 200 registrants, so don’t delay. Register today!

If you are unable to attend the live call, a link will be sent out after the meeting for you to review.

Register Now

Open Letter to Fed Is Best Foundation

ICEA wants you to know that we are part of a coalition of 40 organizations that sent an open letter to the co-founders of the Fed Is Best Foundation on August 15. You will find the letter below.

Dear Dr. Castillo-Hegyi and Ms. Segrave-Daly:

We write to you as fellow advocates for the health and well-being of infants and their families. We believe that we share a common goal—to ensure that every baby gets the strongest start to life. It is in that spirit that we extend an invitation to you to discuss the concerns that you and your organization, the Fed Is Best Foundation, have raised with respect to our nation’s infant feeding recommendations and associated health care practices.

We believe the ground we have in common is far greater than the areas where we may have disagreement. For the sake of all children, mothers and families, we therefore seek ways to unite in a shared vision rather than engaging in divisive messaging. For example, we all agree that the health of the baby is the ultimate goal, that infant feeding is a highly personal decision, that the mother should be fully informed of her options in making this decision, that nobody has the right to impose their beliefs or values on another, and that no infant, mother, or family should suffer as a result of ineffective support or care practices. We also agree that many physicians and other health care providers need improved training and education to ensure the competency to properly diagnose and address infant feeding issues, and that improved continuity of care is needed to enable new mothers to access timely, integrated, and continuous care throughout the prenatal and postpartum periods.

That’s a lot of common ground to build on.

Where we seem to disagree is on the root cause behind the tragic stories that Fed Is Best has recently highlighted. That is where we would hope to engage in some honest and constructive dialogue to find shared messaging focused on providing the accurate and unbiased information families need to make their personal infant feeding decisions, along with the appropriate care and support they need to implement those decisions.

We believe that we can be most effective in serving moms and babies when we attack the root causes of problems, rather than each other. For this reason, we invite you to meet with us to talk about your concerns and discuss ways we can work together to ensure that no family has to endure the pain and heartbreak of a baby who doesn’t get the nutrition they need to thrive. We hope that you will take us up on our offer and look forward to receiving your response.


1,000 Days
Academy of Breastfeeding Medicine
Alabama Breastfeeding Committee
American Association of Birth Centers
American Breastfeeding Institute
American Samoa Breast Feeding Coalition
Arkansas Breastfeeding Coalition, Inc.
Baby Cafe USA
Baby-Friendly USA, Inc.
Best for Babes Foundation
Breastfeeding Task Force of Nevada
California Breastfeeding Coalition
California WIC Association
Childbirth and Postpartum Professional Association
Eastern Kentucky Breastfeeding Coalition
Georgia Breastfeeding Coalition
Healthy Children Project, Inc.
Indiana Breastfeeding Coalition
International Board of Lactation Consultant Examiners
International Childbirth Education Association
Kansas Breastfeeding Coalition, Inc.
La Leche League USA
Louisiana Breastfeeding Coalition
Macomb County Breastfeeding Coalition
Massachusetts Breastfeeding Coalition
Michigan Breastfeeding Network
The Milk Mob
Mom2Mom Global
Mothers’ Milk Bank
Mothers’ Milk Bank Northeast
National Alliance for Breastfeeding Advocacy
National WIC Association
Nebraska Breastfeeding Coalition
New Hampshire Breastfeeding Task Force
New Mexico Breastfeeding Task Force
New York Statewide Breastfeeding Coalition, Inc.
NYC Breastfeeding Leadership Council, Inc.
Ohio Breastfeeding Alliance
Reaching Our Sisters Everywhere, Inc.
Rhode Island Breastfeeding Coalition
Texas Breastfeeding Coalition
United States Lactation Consultant Association
Vermont Breastfeeding Network

Only One Month Left to Submit Your Abstract

Share Your Expertise at ICEA’s Conference

Just one month remains for you to submit an abstract for ICEA’s 2018 Conference on April 19-21, in Louisville, Kentucky, USA!

The conference theme focuses on ICEA’s newly defined core values:

  • COMPASSION: We believe approaching maternity care with compassion and a nurturing spirit improves birth outcomes for all families.
  • COLLABORATION: We practice a culture of collaboration based on the knowledge that mindful engagement with diverse groups advances positive, family-centered maternity care.
  • CHOICE: We support freedom of choice by training professionals committed to empowering expectant families through informed decision making.

If you have an idea for a presentation centered around one or more of our core values, we’d love to hear it! We’re accepting submissions for concurrent sessions, hands-on skills stations, and poster sessions.

All abstracts must be submitted through the online system by 5:00 PM EST on September 15. Abstracts will then be reviewed by the ICEA Conference Committee. Share your expertise today!

If you have any questions about submitting your abstract, please contact the office.

Tips for Successfully Submitting Your Abstract

Submitting your abstract can be easily completed by following the steps below.

  • Create a profile on the submission site– please note that all submitters will be considered First-Time Users this year
  • Complete information about the author(s)-  including bio, headshot, and contact info
  • Share information about your session- including session description, session type, session level, track, etc.
  • Upload completed EPT and COI
  • Make sure to see the submission to fruition- you will receive an email confirmation for each session that you successfully submit

Submit Your Abstract

Engorgement: An Often Misunderstood Condition

by Donna Walls, RN, ICCE, IBCLC, ANLC

When a mother tells you she’s engorged- check in and ask what she means. Too often our patients use the term meaning their breasts are fuller, heavier. Physiologically, this early filling is normal and this process, lactogenesis 2,  is the transition from colostrum to mature milk that occurs in the first days after birth.

Unfortunately, this process is too often referred to as “milk coming in”, interpreted by many new mothers as there is no milk for the newborn until they feel the filling. We know the number one concern in the first days is not having enough milk and continuing to use the “milk coming in” phrase perpetuates this myth. Changing your wording can have a major positive impact on a new mother’s confidence in her ability to make enough milk for her newborn. Referring to lactogenesis 2, when the breasts become rounder, fuller, firmer and heavier, as “milk change over” or “newborn milk changing to mature milk” can help mothers to understand the adequacy and importance of early colostrum feedings.

The condition of engorgement is actually pathological and can cause reduction or cessation of milk production if not alleviated quickly and effectively. When teaching prenatal class or helping a new mother in the postpartum days educate her as to the difference between normal filling and engorgement:

Normal Filling Engorgement
breasts warm hot, shiny
skin indentable skin unindentable
normal temp low grade temp
nipple graspable nipple flattened, tight
baby able to latch unable to latch

Factors which may increase the risk of engorgement are:

  • Use of IV fluids in labor
  • Separating mother and baby resulting in “missed feedings”
  • Scheduled rather than cue based feedings
  • Housing newborns in the nursery at night
  • Limiting or timing of length of feedings
  • Overstimulation- “extra pumping” in the first days
  • Use of “too tight” bras, wraps or clothing

Implementing effective treatments quickly is the key to resolving the discomfort and possible harm to breastfeeding. First, review baby led feeding or assure the mother understands cue feeding. Underscore the importance of non-separation of mother and baby to facilitate mothers’ observation of cues and states optimum for feeds. Ask them to discontinue if they are doing “extra” pumping, as mothers often mistakenly feel this may be helpful in having enough milk. A very effective technique is the water gravity massage, having the mother hang her breasts in tepid water (either in a clean sink or reusable tub) while doing a gentle massage from the base of the breast toward the nipple. As soon as milk begins to flow have the mother place the infant at the breast to begin nursing and effectively remove milk. This may be repeated later in the day if necessary,

As childbirth educators, doulas, nurses or midwives we can be an integral part of reducing the incidence and consequences of engorgement with education and early interventions and Including educating all caregivers in preventive care practices and implementing interventions quickly when engorgement is recognized.

Mary C. Brucker, Applying Evidence to Health Care With Archie Cochrane’s Legacy, Nursing for Women’s Health, 2016, 20, 5, 441
Anne Fallon, Deirdre Van der Putten, Cindy Dring, Edina H Moylett, Gerard Fealy, Declan Devane, Anne Fallon, Cochrane Database of Systematic Reviews, 2016
BREASTFEEDING MEDICINE Academy of Breastfeeding Medicine Protocol #20, Volume 4, Number 2, 2009  Mary Ann Liebert, Inc. DOI: 10.1089/bfm.2009.9997
Bolman M, Saju L, Oganesyan K, Kondrashova T, Witt A. Recapturing the Art of Therapeutic Breast Massage during Breastfeeding. Journal of Human Lactation. 2013;29(3):328­331. doi:10.1177/0890334413475527
 Witt AM, Bolman M, Kredit S. “Breast Engorgement:  Clinical Course, Home Treatment and In-Office Education Breastfeed Med. 2014 Nov;9(S1)

World Breastfeeding Week 2017

In 2016, the World Alliance for Breastfeeding Action (WABA) began the 15-year journey to achieving Sustainable Development Goals (SDGs) by linking each of these goals to breastfeeding. But, WABA cannot achieve sustainable development without multi-level partnerships at all levels.

The World Breastfeeding Week’s 25th year in 2017 is about working together for the common good!

World Breastfeeding Week calls on advocates, activists, decision-makers, and celebrants to forge new and purposeful partnerships. WABA wants us to attract political support, media attention, participation of young people, and widen our pool of celebrants and supporters together.

To learn more about World Breastfeeding Week, or to post an event you’re hosting in honor of the week, please visit their website.