According to the letter that my supervisor let me read - i was stepping out of my scope by trying to "diagnosis" the mother. Since i didn't get the patients name i am not sure what the exact 'problem' was. I am sure that after a good history with mother and i went down the list of potential causes for milk supply problems we found one that could be the cause of the problem and i suggest that she had x lab checked to determine if this was the cause. At that point I was 'diagnosing" the mother. 

I read through all the articles listed and it stays that the IBCLC should 'know' about all the issues that could cause problems but it doesn't say that the IBCLC has the authority to share her belief or findings with the mother. 

I did talk with my supervisor and she asked me to come up with the alogrthim as a supporting document on my end. My supervisor was very understanding. I just need to find something that shows that i am practicing within my scope. 

I started thinking about nurses as well (which I am one). When a nurse is doing phone triage isn't she basically assessing the patients symptoms and making a diagnosis as well. 

Thanks, 

Jessica

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