This was one of the issues discussed by P. Bormann an the last ILCA
Conference.  You might want to listen to the tape of that session.
My approach is that if I am identifying a behavior type problem
(e.g. ineffective positioning or latch) then there is no conflict.
When it gets into identifying a "disease" state as being the problem
(e.g. thrush) the line is indeed murky.  My CYA (for those who don't
like abbreviations that's "Cover Your #**") approach is to say
something like:
   "What I'm seeing (or what you're telling me) is consistent with
thrush.  Since I'm not an     MD I can't make a definitive
diagnosis, but I certainly am suspicious that that's the source of
your soreness."  I then refer them to their doc for Nystatin or
whatever the doc prefers.  I find that many will act on my "hunch"
alone while others won't agree that it's thrush unless the "cotton"
in 1/4" thick on the baby's cheeks!  To be perfectly honest, if I
know who their doc is, that does influence how difinitely I identify
such a problem.
I'd love to see the day where it is written into LC Scope of
Practice to be able to diagnose medical conditions that directly
impact on breastfeeding.  Until that day,we do have to deal with a
number of grey areas and how grey they are will vary from setting to
setting.
Winnie

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html