To Jan and all,
the way I would interpret number 23 would be as follows:

require and obtain consent from client (which I do on my form), to share info with HCP or PHCP.
This to me does not sound like it is a requirement but does leave the option for the LC to share if she deems appropriate. 

If I was required to report to the PHCP, then I would not be able to work. Here in Israel, unless a baby is ill, they just may not have an MD. Most of the consults I do are with newborns, between 4 days old and two weeks. Medical care is provided by one of a number of subsidized Health Services, thus a mom does not necessary have a private doctor. Not even an OB-GYN as most births are performed by midwives in the numerous hospitals, the mom has seen (or not) an ob-gyn on duty at the Well baby clinic which is also virtually free prior to giving birth. But the mom doesn't necessarily see the same one throughout her pregnancy. After giving birth in the hospital, most have no contact with that hospital or the staff after d/c but she goes back to the clinic for weekly weighs and vaccinations, and is assigned to see the on duty Ped. maybe after two weeks or a month. They have weekly visits for General check ups, routine measures (head circumference etc...) so, most of the moms don't even have the name of the HCP which she will see or even has seen already. So there isn't much chance of us getting pertinent information. On a few occasions I had to really do detective work to get the name of a doctor who had seen some moms with really worrying situations. The vital info I take in is the name of the well baby clinic and the nurse who takes care of the mom. At least that way, I can track down more info. In many cases, they cannot even tell me the name of the nurse and more often than not, they see more than one nurse.
Once again, we have to remember that there are different medical setups in different countries. therefore, it would be hard to make rules that are fitting for all systems.

ellen shein, IBCLC
tel aviv



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