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Lactation Information and Discussion

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Subject:
From:
Elizabeth Brooks <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 26 Mar 2010 11:49:34 -0400
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The following comment is made, wtih regard to a mother making an inquiry
about the use of an over-the-counter (OTC) medicationwhile lactationg:

"There are no legal ramifications in recommending an OTC. It is NOT
prescribing! As with anything, we ought to do it being exactly clear about
what our knowledge is and where we are getting our info."

While I agree with the spirit of this statement, I offer up the IBLCE Scope
of Practice for IBCLCs on this point, which says:  "IBCLCs have the duty to
provide competent service for mothers and families by: [P]roviding
evidence-based information regarding a mother's use, during lactation, of
medications (over-the-counter and prescription), alcohol, toboacco and
street drugs, and their potential impact on milk production and child
safety; [P]roviding evidence-based information regarding complementary
therapies during lactation and their impact on a mother's milk production
and the effect on her child."

There is a world of difference between saying "I recommend that you take OTC
Product X" and saying "Let me share with you some information about OTC
Product X".  There are varying levels of  "legal ramifications" than can be
brought to bear if an IBCLC is accused -- rightly or wrongly -- of
overstepping her IBLCE Scope of Practice for IBCLCs.  The bottom line is
that it is a major pain in the neck to find yourself on the receiving end of
an allegation that you are acting outside your scope of practice.

I would suggest that an IBCLC can NEVER go wrong *providing information* to
a mother, that mother is/or even is not encouraged to share with her primary
health care prvider, so that mother can make an informed decision about her
(and her child's)  health care.  As a practical matter, the mother is very
likely to *hear* the IBCLC's information-sharing session as a
recommendation.  But it behooves us to stay on our professional ethical
toes, and to couch the information we share within the parameters authorized
of our scope of practice.

P.S.  Those  who have "extra scopes," like midwives, or nurse practitioners,
or doctors, will of course have a "wider" scope of practice, as granted by
their other professions.  So, an MD IBCLC would have the luxury of saying "I
recommend that you take OTC Product X or even Prescription Product Y,"
because their scope of practice (and licensure, in the USA) permits this.
--
Liz Brooks JD IBCLC FILCA
Wyndmoor, PA, USA

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