Hear, hear! to Nikki Lee and Lisa Marasco for their thought-provoking posts about the quandry for IBCLCs, whose practice-guiding documents do not currently support the "power to diagnose," yet whose IBLCE certification exam questions seem to spring from that very power. I agree with the speaker Lisa heard, who thinks the detailed assessment and analysis IBCLCs offer for many difficult lactation/BFg issues (think: our favorite friend, Mr. Tongue-Tie) make them more than capable of "diagnosing" this physical condition. Indeed, given our *current* IBLCE Scope of Practice and Clinical Competencies for IBCLCs, we *should* be able to do this, and do it well. The "formalized training [to] provide legitimacy to our right to 'diagnose' lactation conditions" suggested by Lisa absolutely will And I will also gently suggest that before we start a flurry of posts about how some IBCLCs are "good enough" to do this and some are not, that entirely misses the mark for what we SHOULD be focused on, which is patient- or client-centered care. Hurling tomatoes at one another in some sort of contest of "I know more about this than you do," shines the spotlight on US, as the healthcare providers (HCPs). I submit that the spotlight should instead be focused on THE FAMILY, and seeking to provide evidence-based information and support for *their* infant feeding goals. It doesn't matter one whit that I am the world's surpreme expert on Lactation Condition X if I am not stopping, sitting down, making a connection, and ASKING the family what is going on and what they want or need. The lawyer in me knows that the IBCLC profession needs practice-guiding documents that strongly support our clinical skill and authority. With a discilinary process that transparently, and with basic due process, permits sanctions for those who do not follow them. I don't think the existing documents and disciplinary process are perfect, by any stretch. But here is the deal: It is what we HAVE, and so it is what we must FOLLOW. The mandatory IBLCE Code of Professional Conduct, Scope of Practice, and Clinical Competencies are all freely accessible on the IBLCE webiste, and are a grand total of about 10 pages to read. I think every IBCLC should do so (that is: read them, word-for-word), at least annually. The voluntary ILCA Standards of Practice, and Position Paper on the Role and Impact of the IBCLC, offer further girding for our incredible cross-disciplinary skill and expertise as members of the healthcare team. That is another 6 pages. Its a foggy day here in Philly. Good day for a little downloading and reading! -- Liz Brooks, JD, IBCLC, FILCA Wyndmoor, PA, USA Secretary, U.S. Breastfeeding Cmte (2014-16) Director, Human Milk Banking Assn of North America (2015-18) Adjunct Professor, Drexel Univ, Public Policy of Breastfeeding (2016) "IBCLCs empower women and save babies' lives!"-Ursuline Singleton *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome