<< don't think I have ever seen others working by email (not as an adjunct
to other practice, but as first, maybe only, point of contact) discuss their
practice here on lactnet. Surely you are out there>>
I'm a little late getting in the discussion as usual. I thought I could add
my expertise and opinion to the list.
My current "practice" is almost entirely via the Internet and has been for
the past 8 years. I hear from women all over the world . In many cases, I
am the only LC they have access to because there isn't anyone available
locally. This is unfortunate , but, I often hear that even though they
saw someone in the hospital, no one is available to them after discharge or
because the baby is older than 2 weeks they can't go back for help and no
one is in private practice in their area.
Women today tend to scour the Internet for any information and the result is
often a disaster. Those of us who have sites try very hard to get any
common problems covered in the simplest most general way possible--quick
questions and easy answers, the type a mother could find in any book.
However, a little knowledge is a danger and self-diagnosis has many
drawbacks and pitfalls. My web pages have general advice and an invitation
to mothers, who need additional assistance, to contact me via email. I
receive an average of 3 or 4 requests a week. Unfortunately, most of the
moms who contact me are well beyond simple answers. Many have badly
mismanaged the problem based on what they have read "somewhere on the
Internet."
Treatments for some specific problems are purposely omitted on my site. The
answer to the problem is available to those who ask, if they are willing to
provide whatever information I require before I give them any treatment
recommendations. I just don't feel comfortable distributing information
when I don't have all the facts. Over the years I have learned that some
mothers either exaggerate or under report what is happening. Things can get
very complicated, very fast, if the picture is incomplete. I wouldn't use
SMS's or IM's for that reason.
The vast majority of cases I get are Over Supply Syndrome. (The topic I
spoke on at the 2008 ILCA convention in Las Vegas.) When mom contacts me I
send her a questionnaire that is intended to give me a complete history and
description of the problem. When it is completed and returned, I can make
recommendations for how she can best handle the OSS. Several email contacts
may go back and forth after she gets treatment recommendations to make sure
the treatment(s) is working. Adjustments can then be made accordingly.
For problems other than OSS, I created something I call an "ichart". It is
sent to moms who ask for help with low supply, persistent sore nipples,
latch on problems, etc., and contains screening questions for a myriad of
complications. When I was practicing *hands on* (face to face), I learned
that the history is a key diagnostic tool. What I saw in the exam often
proved secondary and only confirmed the impressions I had formed regarding
the diagnosis and treatment needs from taking the history.
I also use other internet tools like still photographs, Skype, and /or live
webcams, as needed.
Every woman who makes contact with me is informed that 1) I only help with
feeding problems,2) contact with their local LC or baby's doctor is
preferred to email contact, 3) take the baby to the emergency room if it
appears ill, and 3) if baby gets worse see your doctor, etc ... A
disclaimer that covers those points accompanies every email.
The anonymity of the Internet seems to permit moms to share things with me
that they would never share otherwise. Breastfeeding practices are more
varied than we as a profession imagine. Women's perceptions of LC and
physician support of breastfeeding, or lack thereof, are quite a revelation.
Nevertheless (not to brag) I think I am quite skilled in internet support.
It does have one additional drawback that no one has mentioned-fee for
service. I do wish I could charge for my services but it is nearly
impossible to do and because I am often the only access many of these women
have to LC help, I worry a fee would make me inaccessible as well. If a
woman offers payment, she can make a donation through PayPal but that doesn't
happen very often.
I do get something out it, there is a certain satisfaction knowing I've
helped a baby stay breastfeeding (oh and it keeps me feeling useful too).
I'd be happy to answer any questions.
Happy holidays and hope for a peaceful New Year
Marie Davis RN IBCLC
[log in to unmask]
***********************************************
Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome
|