Systemic yeast: Thanks to those who have had input. I will look at the
book suggestion.  I have seen resistant cases of localized yeast and
cases of yeast that appeared to be in mom's milk ducts.  One of my
concerns is over people who seek systemic medications for their "systemic
yeast" which makes me uneasy.

Qualifications: I must agree with Kathleen A.'s and Anne Norton's
comments regarding the qualifications issue.  One of my biggest
frustrations is the frequent incorrect advice that women are given by
well-meaning physicians and nurses. Despite the fact that I am an IBCLC,
I find that many women listen to whatever their physician tells them
right or not.  And the problem of getting different advice from anyone
who walks in the room to care for a woman seems to be endless.

  Expecting all HCP's who work in maternity to become IBCLC's
sounds a bit extreme and not practical.  However, I believe that much
more attention could be given to integrating practical and correct
information into the various professions: nursing, medicine, midwifery,
etc.  I believe that in doing so, it is important to address cultural
attitudes and biases toward breastfeeding in a conscious manner such as
the belief that "breastfeeding really isn't that important"; that "infant
feeding is just a matter of personal choice", etc.  It is also
desirable for health care practitioners to receive information about
lactation consultants, what the LC's scope of practice is, how to work
with LC's.

When I went to nursing school, we were extremely fortunate in that
the LC at University Hospital spoke to our class in our maternity
rotation and making rounds with her once was part of our clinical
requirement.  There was a senior practicum in the last year of my program
where we could arrange to get more expertise in an area of our choice. I
was fortunate enough to get to work with the LC's at an area hospital for
the entire quarter. It would be wonderful if such options were available
to more students.

Ione Sims, GNM, IBCLC