Dear Debbie,

From what you write, you sound pretty upset because you feel that you lost a
fee for a consultation because another Leader offered to do the sns teaching
session as a volunteer La Leche Leader. You feel that this Leader stepped
out of bounds. You assume that there was no financial problem in the home of
the mother.

The following quote comes from the LLLI Leader Handbook. It talks about when
a Leader might decide to make a home visit. While a hospital location is not
mentioned, it is clear that a hospital would be included in the definition
of an on "site" visit.

"WHEN HOME VISITS MAY HELP

Although most mothers' questions can be answered over the telephone, some
situations are more effectively handled in person. Sometimes a problem that
takes several phone calls to figure out can be resolved immediately when the
Leader can see the mother and baby. Situations that may require a home visit
are:

- When a baby is refusing to breastfeed or having trouble latching on

- When a baby is not gaining well and the usual management suggestions are
not helping

- When a mother has persistent sore nipples and over the phone suggestions
have not helped.

- When a mother needs a breastfeeding aid product such as a breast pump or
nursing supplementer.

AN OPTION FOR THE LEADER

Whether or not to make home visits is a personal decision each Leader must
make for herself. Home visits are optional and not considered one of a
Leader's basic responsibilities. If, due to family needs or other factors, a
Leader decides not to make a home visit when it seems necessary, she has
other options for making sure the mother gets the help she needs.

- After consultation with another local Leader, the Leader may make
arrangements to have the other Leader meet with the mother instead.

- If the monthly meeting is being held soon, the Leader can make
arrangements to have the mother come there for help. The Leader can give her
personal attention either before or after the discussion. .....

- If no Leader can make a home visit when it seems to be necessary, the
Leader can refer the mother to a qualified lactation consultant if the
Leader knows one in the are who would be able to help. In this case the
mother should be advised that the lactation consultant will charge a fee for
her services."

LLLI Leader's Handbook, LLLI, Franklin Park, 1989, pp 32-3


Devorah