I took my recent post to Lactnet about the scope of practice and adapted
it into an email to IBLCE.  While writing it I decided that the thing to
do, or one thing at any rate, is to put this dilemma in their laps.
What are we supposed to do, if a woman tells us that her HCP has said
something we know to be flatly incorrect?  

 

So as not to repeat everything that I said in my most recent post, I'm
going to copy below an edited version of my email to IBLCE.  I am very
curious as to what kind of answer, if any, I'll get from them:

 

<<The item about contradicting the advice of health care providers needs
to be reworded.  That is too broad a statement, encompassing even the
most basic yet very common sorts of erroneous statements that many
health care providers in the USA say every day.  Sometimes they are just
flat wrong, and as proof I submit just two examples from my own
practice:  1) wean your child for 24-48 hours after taking TYLENOL; 2)
no breastfeeding mother may take any medication during breastfeeding,
ever.  A woman in that situation needs and deserves to know, for
example, what the AAP has to say about the issue (Tylenol is considered
by the AAP to be usually compatible with breastfeeding).  The list of
potential "contradictions" with a doctor is fairly endless, depending
upon the doctor and your definition of the word "contradiction".
Unfortunately many of them just don't know enough about breastfeeding.  

 

......(snip, same as earlier post)

 

One is tempted to think that no one who contributed to this Scope of
Practice has ever actually PRACTICED as an LC.  On what planet is it
possible never to express to a client disagreement with what a doctor
has said to her about breastfeeding?  My own father, who is a
pediatrician, thought that my eldest child's bowel movements were
DIARRHEA.  He actually took the child off breastmilk for 24 hours and
instructed me to give him Pedialyte instead.  What were Matthew's stools
like?  Yellow, seedy, loose, and frequent - after every feeding.  He was
fine; he did not have diarrhea.  My dad - his pediatrician - simply did
not know any better.  

 

If a client comes to me with a similar story I am NOT supposed to tell
her that what she has described to me is the NORMAL stool of a breastfed
baby?  That's my reading of the new Scope of Practice.  That makes no
sense.

 

I also recommend that the "alternative therapy" item be re-written, as
it is too vague a term.  ....(snip, same as earlier post)

 

I am concerned about this.  IBLCE, you need to clarify for us just what
we are supposed to do in situations such as the ones I have described,
where we know, based on the evidence, that the client has been given
egregiously erroneous information about breastfeeding by her health care
provider.  Does this Scope of Practice forbid us to give her the correct
information?

 

I am eagerly awaiting your answer....>>

 

And indeed I am highly curious as to how they will answer.  I can't
believe they actually thought this through....

 

Regina, trying to be happy that she passed her exam for the second time
in a row

 

 

 


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