>> Do I write it down for her (such as the dosage of Fenugreek)?  Yes, I do.
Do I tell her that as an RN I'm not allowed to tell her what medications or
herbal preparations might be helpful for her low milk supply or yeast and to
go ask her doctor?  No, I don't.  I tell her exactly what I would recommend
based on my experience.  This is part of my role and and my responsibility
as a lactation consultant.<<

Thank you, Jan. I also come from the perspective that being a
board-certified lactation professional qualifies me to share what I have
*learned*; is that not what mothers come to us for? A while back I faced the
decision of whether to restrict my suggestions and discussions with mothers
to the things that are officially approved, or whether to give them the
benefit of my wider knowledge base. When it comes to situations where the
usual protocols have not been effective or are contraindicated for some
reason, I have committed to sharing every resource I've learned, because
that is what I would want done for me in the same situation. I work hard to
present the facts fairly and to empower the mother to make a choice when she
has one; this can be especially critical when the local HCPs are
unknowledgeable in a particular situation.

>>If a mom calls and wonders what to take for a cold, I will ask her, "What
do you usually take?"  She says, "I want to take Nyquil."  My job is to look
it up and give her the written recommendations regarding Nyquil and
breastfeeding. She might then ask, "What do you recommend?"  and I might say
something like, "most OTC, one ingredient, short acting medications are OK
w/ breastfeeding."<<

This is how I try to handle these scenarios, also.

You know, if this is not clear enough in our profession, then we need to
make it clearer. I honestly don't know how effective we can be if we back
ourselves into the corner of not sharing what we know might be helpful. I do
believe that good communication skills are essential in this process, and
that sharing of non-standard information without proper disclaimers can be
dangerous. Let's work on how to do this right, rather than ban it out of
fear.

Lisa Marasco, BA, IBCLC

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