At the risk to starting a flaming war (NOT my intention), I must object to the assumption that only RNs would pick up on some serious conditions. In my time (as a non-RN; never have been an RN) I have picked up on cleft palate (not identified in pediatric exam), failure to thrive not paid attention to (more than one of these), Hirschsprungs, heart problems (AFTER I raised concerna bout baby's color, heart defect was identified and baby had surgery within the week(!)), broken clavicle (had gone more than 2 weeks unidentified why baby refused to nurse on one side and cried in pain whenever held on that side), and hypotonia. I am not suggesting that all non-RNs will know everything an RN/LC knows, but surely those of us in the field who come from a variety of backgrounds can learn to work TOGETHER, in CONJUNCTION with one another and learn from one another and BROADEN the ways in which each of us looks at mothers and babies breastfeeding. I have always viewed the breadth of backgrounds in lactation consulting to be a BONUS, not a hindrance. If we all do not share this view, LCing will quickly go the way of childbirth education in so many places, where only RNs can teach the classes and what is taught is limited to what is ALLOWED by the MDs who would prefer mothers don't know about epidural effects and the like. Having begun teaching mothers as a childbirth educator when they were still very much independent entities, I still weep at what has happened in the past 25 years to that wonderful group of committed individuals. Will LCdom become an ICEA (non-RNs and non-medical approach) and ASPO (RNs and other licensed individuals and highly medicalized approach) who really don't talk much to one another? I surely hope not. mailto:[log in to unmask] "We are all faced with a series of great opportunities brilliantly disguised as impossible situations." Kathleen G. Auerbach,PhD, IBCLC (Ferndale, WA USA) [log in to unmask] WEB PAGE: http://www.telcomplus.net/kga/lactation.htm LACTNET archives http://library.ummed.edu/lsv/archives/lactnet.html