>I find the discussion of the legalities/ethics/liabilities of lactation >consultants "prescribing" treatments to be very interesting. In the US, we >are very focused on CYA medicine ("Cover Your Ass") and who might get sued >under what circumstances. Parallels here, too, Kathy. This week I gave a talk to a room full of doctors (GPs and SHAs mainly - ie family practitioners and Senior House Officers, which is the most junior sort of trained hospital doctor) doing a module in child health. I told them (trying not to beg!!) about treating mother and baby for thrush, and how systemic treatment for the mother could help deal with persistent thrush that gave the shooting pains we so often hear about. Now, systemic anti-fungal treatment for lactating mothers is not licensed here - doesn't mean it's harmful and in fact the dose recieved by the baby would be minute and less than what the licensed paediatric oral product would deliver, anyway. But these GP docs did not want to *use their clinical judgement* and prescribe 'off label'. They said 'it's ok for hospital doctors, they have the protection of the hospital' and the hospital docs agreed - a recent study showed that 50 per cent of children treated in UK hospitals get off-label meds, so it's done almost casually in an institution. But outside, in the community.....they want to stick to the data sheet, which tells them what to do. I sympathise. Doctors do feel pressured and unsupported - but it's a shame mothers are having an unnecessarily painful time bf. I don't know what the answer is. Heather Welford Neil NCT bfc Newcastle upon Tyne UK *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html