Question 1: What remote lactation consulting techniques have you piloted/used? Rojjanasrirat: My colleagues and I piloted the use of in-home real-time videoconferencing (VC) in a research setting, 1 to determine the feasibility of using it to provide breastfeeding support to motherinfant dyads and to assess the reliability of the LATCH breastfeeding assessment tool. The in-home videoconferencing equipment included a small computer-attached camera, point-to-point encrypted videoconferencing software, a desktop or laptop computer with a minimum bandwidth of 384 kbps, external speakers, headsets, and microphones. 2 Sanders: The Texas Women, Infants and Children (WIC) Program uses video technology for IBCLC lactation consultations. WIC is a US Department of Agriculture supplemental food and nutrition, breastfeeding promotion, and support program. Our target population is low-to middle-income women who are either pregnant, breastfeeding, or postpartum, and infants and children to age 5. Texas can be geographically challenging. We have large urban areas with heavy traffic congestion, and vast, remote rural areas. Transportation is a major deterrent to residents of these areas accessing professional lactation care. WIC is a federally funded program with limited resources; we needed a low-cost solution that was convenient, inviting, and effective. Video conferencing was selected as the technology to provide distance IBCLC lactation care.Our IBCLC is located in a centrally located breastfeeding support center. The local WIC clinics are located in areas that are typically geographically close to the mothers' homes. Our clients visit their local WIC offices for the consult. The mothers are never left alone during the consult. They are assisted by a remote site assistant under the direction of the IBCLC via webcam. The remote site assistant can be a peer counselor, nutritionist, or dietitian; they help the mother with positioning and operates the camera for more diagnostic viewing.

United States Lactation Consultant Association (USLCA) would like to clarify some inferences from the commentary, "Can't We All Just Get Along?" 1 USLCA agrees with Dr Long and Ms Bugg's comments regarding diversity in the profession. Achieving equity and diversity has been part of the USLCA strategic plan for the past 2 years. We recognized the need for a voice of the community to guide our organization toward real change and contacted Sherry Payne, MSN, RN, CNE, IBCLC, who is director of Uzazi Village, a nonprofit dedicated to decreasing health disparities, and a member of the editorial review board for USLCA's journal, Clinical Lactation, to ask for guidance. The August 2014 issue of Clinical Lactation was completely devoted to equity issues. USLCA is working to understand and meet the needs of those who may be underrepresented, underserved, or overlooked. We also agree that "a concerted effort, creativity and patience" are needed to increase diversity in the International Board Certified Lactation Consultant (IBCLC) community. 1 USLCA asserts that licensure increases both equity and access to the profession. Licensure allows for a definitive scope of practice, ensuring public protection from unqualified providers. Licensure is often a prerequisite for reimbursement and formal recognition as a profession. The cost of entry into every profession is expensive. USLCA believes that the breastfeeding relationship of all mothers and babies are worth the professional services of an IBCLC.Dr Long and Ms Bugg state, and USLCA agrees, that the level of lactation support required by families varies by circumstance. Dr Long and Ms Bugg state that some issues require someone with more "expertise such as a CLC [Certified Lactation Counselor] or an IBCLC." 1 This statement implies that the 2 are equivalent providers. One has only to compare the requirements of the IBCLC and CLC to see that such is not the case. Years of experience in one role does not qualify one to practice in another.The work of USLCA is guided by our mission: "to advance the IBCLC within the United States through leadership, advocacy, professional development and research." Advancing the IBCLC must happen in an environment of mutual respect and collaboration from within and outside the profession. The title of the commentary by Long and Bugg is "Can't We All Just Get Along?" Our deep desire is to do just that as we carry out the mission of our organization and meet the expectation of our members.