I have been very busy the past few days not reading my e-mails, so when a colleague called 
today to talk to me about the recent posts on Lactnet regarding the new rules by IBLCE, I looked at 
my calender to see if it was April Fool's Day. O.K. Not really, but you get the gist.
 I am frustrated by it and would like to share some of my thoughts.

I have to respectfully disagree with a previous post stating that

... "but we all have to work within a framework: like it or not. "


If we feel that something is not right, how will ever bring about the changes we feel are needed if 
we don't try and do something about it?


If we just quietly accepted rules that didn't make sense, wouldn't women still not have the right to 
vote? Or put under general anesthesia when delivering a baby? And the list goes on and on...

There are so many scenarios playing in my mind (real and hypothetical) that I really don't see how 
anyone can think that this will not impact our profession in a profound and, in my opinion 
negative way. To say that I feel my hands have been tied is putting it mildly.
If a mother calls me tomorrow wanting to be seen and I triage her over the phone finding out that 
her ped advised her to supplement her baby with formula due to weight loss issues and rising 
levels of billirubin, Oh, and by the way he told her not to pump, just feed the baby for 5 min. each 
side and then give a bottle of formula, "but no need to pump since she is breastfeeding enough." 
What do I do? Do I go to see her knowing very well that even if I see during the consult that baby 
indeed needs to be supplemented, I know that if she pumped she will be able to 1) provide her 
baby with her breastmilk and there will be no need for formula and 
2) that if she didn't pump her supply will drop significantly and she will most likely stop bf shortly. 
Am I then forbidden from writing the care plan that I think is essential for her and her baby to 
follow? Lets assume I agree with the supplementing part, am I allowed to suggest pumping? It 
goes against the peds instructions. So do I say? O.K. Continue to supplement. I'll talk to you soon. 
Go home. Fax ped a letter requesting permission to alter plan and then wait? What if they get back 
to me 2 weeks later? Or more likely, what if ped isn't getting back to me at all?  Don't I have an 
obligation to the mother as stated by other IBLCE rules?
 This by the way has happened only a couple of weeks ago. So not so hypothetical.
I join the scores of you contemplating the way we are treated by the body that governs us, and 
seriously debating re certification.
Respectfully,

Ayelet
-- 
Ayelet Kaznelson
CLC, IBCLC, RLC
Lactation Consultant
w - 310-943-9002
c - 917-620-4068
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