Background:Certification as a lactation consultant is based on practitioners having achieved a standard of knowledge indicative of their competence to practice by passing a psychometric examination. The underpinning principle of recertification programs is to support clinicians to become lifelong learners by progressively enhancing and advancing their knowledge and skills in line with contemporary evidence. The aim of this study was to investigate the factors that influence International Board Certified Lactation Consultants (IBCLCs) to advance their practice.Method:A mixed-methods study was conducted in two phases. Phase 1 included focus groups, interviews, and participants’ demographic data. Phase 2 comprised of an online questionnaire to IBCLCs. This approach was designed to provide a comprehensive qualitative understanding of the IBCLCs’ experiences, which was then triangulated with quantitative data from a significantly larger population of IBCLCs in Phase 2.Results:The findings are described in themes and subthemes. Participants in phase 2 (n = 3,946) reported being intrinsically motivated (93.3%, n = 3,631) and committed to providing evidence-based guidance and optimal care to support breastfeeding mothers. They identified various sources of continuing education, although attendance at conferences, peer support, and reflective sessions were the most common approaches to enhancing knowledge. They recognized that it was through extension of knowledge that they were able to advance their practice.Conclusion:This article identifies strategies that the managers, educators, and certification bodies can adopt to support the IBCLCs in continuing to advance their practice, which will ultimately improve breastfeeding outcomes for mothers.

In this article the author looks at how midwives can plan the care they give women in the antenatal period to be consistent with the principles outlined within the recently published NICE antenatal care guideline. Midwives are encouraged to think about services with vision and focus on the enabling aspects of the guidance in their interpretation and approach to implementation.

Are the NICE antenatal guidelines a new set of rules dictating our practice and creating cuts in services, or do they present us with an opportunity to reform and modernize antenatal care? I take the latter view. This is an opportunity to structure a service based on a woman's needs and deliver a schedule of care that is relevant and based on sound evidence. However, some individuals will see restriction rather than opportunity.

The Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) was established in 1992 to ‘improve understanding of how the risks of death in late fetal life and infancy from 20weeks of pregnancy to one year after birth may be reduced.’ Data is collected on a regional basis using a network of regional and district coordinators. All fetal losses and deaths under one year are reported using the standard rapid reporting forms, and ascertainment when compared with Office for National Statistics (ONS) data continues to rise. The current level of reporting is 1.3% below that of the ONS, compared to 4.0% below in 1995.

As midwives today, we find ourselves in an exciting and challenging position. While striving for professional excellence through our efforts to gain academic recognition for our clinical profession, how can we ensure that we remain ‘with woman’?