International challenges all over, indeed.
  I do not report to any HCP unless on *my* clients own and explicit request or if I want to refer my client to another HCP for treatment out of the lactational scope. Even then, ofcourse, the client will have to agree that I share my observatios and lactational diagnosis with others.
  It is neither unethical nor illegal for me in my country to act in this way.
  When I get an occasional client referred to me by an HCP I will, on HCP's request and with client's permission, report back. I treat this as an inter-disciplinairy professional consultation.
   
  When I visited my gynaecologist for perineal problems, he referred me to a specilised PT for treatment. He did not ask nor get a report from her. He wouldn't expect a report from me if he'd send a patient to me for lactation care. Unless, ofcourse he'd send her to me carrying a note saying ''Dear IBCLC, I saw Mrs A today with <<<troubling symptoms>>> while breastfeeding. Could you see her and send me your observations and recommendations for treatment?''
   
  Warmly,
   
  Gonneke, IBCLC in private practice without hierarchic report system, LLL, in southern Netherlands.

heather <[log in to unmask]> wrote:
  >Micki, IBCLCs need to send an HCP report on every consultation or 
>helping situation they do. It is unethical otherwise.


Interesting - I think I am right in saying that it's the opposite 
here: IBCLCs in private and state practice in the UK would be 
*breaking the law*, and considered to be acting *unethically*, if 
they did this unless the client gave permission to do so.

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