I believe that we SHOULD voice our concerns to the mother if we think,
suspect, feel, etc. that a medical problem exists. While we aren't
diagnosing, I think that we need to make it clear to the mother that she
MUST consult a doctor. Case in point: during a telephone consult, the
mother told me that she had been treated for vaginal strep perinatally;
her three week old was now fussier than usual (which CAN happen at three
weeks) and she had strange sensations in her breast. My gut feeling was
that the breasts weren't draining well; however, I also felt that since
there was a history of strep, it was IMPERATIVE that the mother let both
the pediatrician and obstetrician know that she was experiencing some
kind of symptoms. The mother was totally unaware that this could be a
serious infection in the baby, or that she could have a mastitis caused
by strep.
The problems resolved with better feeding positions, and there was no
strep, but I slept better knowing that she had  consulted with
physicians.
Pearl Shifer, IBCLC