This has become a very thoughtful & insightful thread--one which I have
considered often--I even wonder if telling a mom to use Lanolin cream is a
problem when I work in a hospital setting!! (except that one of my favorite
BF friendly pedi docs just snorts and says "sheep sweat" under his breath!!)

 I think that it boils down to 2 things: 1). is what one is doing
(prescribing, recommending, providing info, empowering, etc) what others at
that same level of expertise are doing (reasonable standard of care)?? Here
ILCA and IBLCE should come into play as having written standards of practice
and 2). has the individual practitioner had the appropriate
training/education to be doing this?? (must be able to show evidence of
appropriate courses/training)

As a RN, one is held to a higher standard of education and care than a
non-licensed person; as an Advanced practice nurse, a higher standard yet; if
one is a physician, a higher standard, and if certified as a specialist in a
given field (e.g. brain surgery), even more expertise is expected (just look
at malpractice insurance rates). One is held to that expectation of what
another similarly trained expert would do (that's what expert witnesses
testify about in malpractice cases, no??). As an Advanced Practice Nurse
certified in adult, I would NOT have been able to care for infants unless I
could *prove* that my nursing education had also prepared me to do so with a
minimum number of course hours (which is why I became a *Family* NP--so that
I could do moms & babies)

If one is comfortable that they have taken the appropriate educational steps
to allow them to have expertise in an area, and acted as any other
"reasonable professional similarly trained"  it would probably be held up in
a lawsuit (but I am NOT a lawyer). But there is still that fine line of
"practicing medicine" that the AMA (MD's please do not take personal offense)
holds to as *their* area. Be careful about crossing that line; it is not
always well defined, and telling a mom to TAKE Ibuprofen could be construed
as that!! (telling her that Ibuprofen has anti inflammatory properties and
would work better for mastitis --i.e., providing info so that she can make an
intelligent, informed decision-- I feel, is not crossing the line).

Great topic--let's hear what others have to say!!

Kathy R. in NJ where the forsythia & daffodils are in full bloom; awaiting
magnolias & tulips now.....springtime is the nicest time in NJ!!

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