Liz, thank-you for working through this with me.  I really respect your knowledge and opinions.  I think we're in agreement except for this point.

<The Leader should provide compassionate
support, information and encouragement to the mother. That's what Leaders
do. >

Leaders may also, to the best of their abilities, provide hands-on care.  Just like IBCLCs, we do not diagnose but we may assess if we have the knowledge to do so.  We may not give medical advice but we may touch mom and baby (with permission) in order to assess and give information that allows mom to decide what she wants to do.

So, as a LLLL, If I am helping a mom with latch difficulties, I may, with permission, examine baby's lingual frenulum.  Further, I may tell mom that research shows that a baby with a tight, palpable residual lingual frenulum may have trouble latching.  I may also tell her that research shows that frenotomy helps some of these babies improve their latch dramatically.  I will go on to explain the known risks of choosing to do the procedure and the risks of not choosing to do it.

I carry this paradigm into my IBCLC practice.  I believe that moms do best when they feel empowered with information to make their own decisions, rather than just being advised.

The orignal post to which I was replying was to a LLL leader who thought she was not covered by LLL insurance while providing hands-on care in her *volunteer* capacity.  It is my understanding that she is.

Also, a LLLL may have a different *opinion* about self-referral but LLL is very clear on this subject.  As a LLLL we agree to follow LLL policy and we sign a statement of commitment.  If a leader self refers, she is breaking this commitment with LLL and is risking her leadership and her LLL insurance coverage.

If I am missing something here in regards to my IBLCE code of ethics (now professional code of conduct) I would be very grateful to know this.

Laura Spitzfaden, LLLL, IBCLC

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