Fer cryin' out loud.  What IS IT with docs and frenula?

(1)  Take your IBLCE Code of Ethics, IBLCE Scope of Practice, ILCA Standards
of Practice.  Also bring something from the IBLCE that spells out just
what-all you had to do to become certified with the only
internationally-recognized credential focusing solely on breastfeeding and
human lactation.

(2)  Take a look at the hospital's website, mission and vision statements.
I am willing to bet they have something there about how they love to give
good care ... they love patients ... they love to be wonderful .... they
love good care healthcare yadda yadda yadda.  Print It Out.

(3)  Explain that your practice-guiding documents require and entitle you to
provide evidence-based information and support to mothers about matters
affecting lactation -- which you did.

(4)  They also require you to be a part of the healthcare team, bringing to
the attention of others (i.e. the docs) matters of interest to them as THEY
provide evidence-based information and support to their patients -- which
you did.

(5)  You offered ASSESSMENT of the baby's skills and abilities ... and an
ASSESSMENT of the impact on the mother -- all of which are clearly within
your scope of practice and demonstrated expertise.

(6)  Remind them that you were working with mothers who have said "I Want To
BF."  Hospitals and healthcare providers -- including IBCLCS -- should be
making it easier for mothers to exclusively breastfeed.  Take the Surgeon
General's Call to Action to Support BF to underscore:  this is considered a
national public policy imperative now.

(7)  You know to take research and protocols that SUPPORT frenulum division
to facilitate BF ... esp. those from the AAP Breastfeeding Section (since
they got that one so wrong).

(8)  Show them the new website http://tongue-tied.net/ -- not to be confused
with a similar one tongue-tie.net -- that demonstrates that an entire field
of research and practice is arising around tongue-tie diagnosis and
treatment.

(9)  Whisper the words "Joint Commission" and "exclusively BF" and "national
quality core measure" in the same sentence.

(10)  And smile smile smile when you ask.  "SO.  What can we do to make sure
that we meet the vision and mission of this institution to provide
compassionate evidence-based health care to our patients?  How can we
support mothers who have decided to exclusively breastfeed, which we know is
the biologic norm and is the basis for a lifetime of improved health for
both mother and baby?  How can we give the mother the best evidence-based
information so that *she* may make an informed decision about the health
care for herself and her baby, as is our duty as HCPs?  How can we improve
our overall exclusive BF rates (one of the Joint Commission's core measures
now) when pain to mother and poor milk transfer are reasons for premature
weaning?"

This just steams me -- this situation is so common (at least in the USA) it
is frightening.  IBCLCs are being bullied and muzzled out of doing what we
are *trained* and *paid* to do.

Evelyn Jain MD (she of the famous tongue-clipping videos) said it best (I
paraphrase here): It is not normal when a body part meant for movement can
not move.
-- 
Liz Brooks JD IBCLC FILCA
Wyndmoor, PA, USA

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