Lee-Ann Halbert brings up some points which are always worth considering
again as we ponder our emerging profession.  Linda Smith wrote a wonderful
paper a few years ago where she compared the roles of LCs to  LLL Leaders
and peer counselors.  This was a role deliniation approved by both LLL and
IBLCE, and it addresses the scope of practice of LCs.  I wish this report
were more widely disseminated and discussed, because there is still so much
confusion on this issue.

  ILCA  publishes the Scope of Practice for LCs which is required reading
for those in practice.  IBLCE publishes the CODE of ETHICS for LCs.  The
purpose of having a scope of practice is consumer protection.  The public is
best served when members of health care teams take very seriously their
roles and  limitations, and practice within an ethical framework and a scope
of practice.  LCs don't prescribe meds unless they also are MDs or CNMs or
PAs with prescribing perogative. We can certainly share information and
topical OTC measures, tho we have an ethical obligation to investigate the
safety of these suggestions.  By that I mean we are obligated to go to
orginal research sources and check references. It is not enough to hear a
suggestion made or written casually and just start in using it because it
sounds good.  An example of that is Neosporin.  It is not a good choice for
topical nipple infection.  It contains an ingredient that may pose a problem
for young infants.  A better and safer choice is Polysporin.  Both are OTC,
but there is a difference in safety.  My source for this info is Tom Hale,
and I checked it in some other refs.

LCs  do work with and under the supervision of MDs.  I am not personally
affiliated with a specific medical practice even tho most of my referrals
come from MDs.  But I closely communicate with the supervising physicians,
and word discussions of meds. carefully.  There are ways to say: " this
mother needs a script"  for something without threatening the MDs perogative
to be the one to decide that.  Remember, our role is to be the bfg expert;
the MD is obligated to have an overview of other health risks.    Learning
tact in our communications skills is part of what we need in order to be
accepted by the existing professions.  Learning our limits and exercising
restraint in not exceeding the appropriate scope of our practice is how we
will demonstrate to the other professions that we are not dangerous.  This
does not mean we don't bravely advocate and educate when we encounter
ignorance of bfg management in a colleague -- we just have to learn to do it
smart so we don't alientate our best referral source.

Barbara


Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html