I have heard that WIC doesn't have to follow HIPPA guidelines because it 
is not health care. BUT, you are exactly right that sharing the rest of 
the story is not totally ethical. Mom must give written permission.

At my WIC, we are now insisting that the client (mom) call us and we 
will not initiate any pump loans, phone calls, help, etc. when the 
hospital/friend/grandmother/doctor calls us about mom. We take down the 
information and ask the other person to have mom call us herself. We 
have to assess her our way to find out her goal and we do not just 
assume that what the hospital/friend/grandmother/doctor wants is what 
moms wants. We are not supposed to share information with the caller who 
is not the client.

And personally, from being on both sides of the issue, in hospital LC 
and outpatient LC, it works best if mom initiates and if BF is truly her 
goal. Otherwise, nothing works and lots of time and money are spent 
needlessly.  But to not initiate is a choice. Maybe it sounds like the 
hospital, the doctor, or WIC didn't "help" her but the reality is 
sometimes very different.

And there are always at least two sides to the story. I try to ask a lot 
of questions and sometimes I go back and ask the question a second time 
to try to ferret out the real scoop. Sometimes moms speak in code. "It 
is too hard" or "I am too busy" or "I am too tired" may mean she isn't 
willing to put that much effort into this plan of action even when they 
say they "really want to BF".

Kathy Eng, BSW, IBCLC

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