In reading the multitude of SOP responses, I am wondering why so many of
us are feeling outraged.  As an RN/BSN, I am aware that I cannot tell a
mother to take or use a medication, that would be out of my nursing
scope of practice as well as IBCLC.  I can tell her that many mothers
have found a medication to be helpful and advise her to ask her
physician if that would be appropriate for her, give detailed
information to give to the MD, or even speak to the Md myself to give
evidence based information to them but I cannot tell her to use it
because that is legally prescribing.  Those of us that are doing so,
should not be. This is what a scope of practice is for. While I do have
a nursing license, I was also involved with LLL when my children were
babies and the issue is always addressed with LLLL, and I believe
appropriately handled.  A League Leader is well trained how to make
suggestions without going against medical advise or prescribing
medications etc...  In regards to giving information against doctors
advise-we can tactfully give evidence based information without stating
that the physician is a quack and does not know anything about
breastfeeding regardless of the reality of the situation.  We all have
to work as a team together and when it comes down to the bottom line,
the physician has the legal responsibility for the medical well being of
the patient and the parents have the final decisions.  Having said this,
I am not suggesting that we stop advocating for and helping mothers and
babies as we do, but that we avoid stepping into the scope of practice
of physician or nurse practitioner.
Angie Kirkwood RN,BSN,IBCLC

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