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Subject:
From:
Lisa Marasco IBCLC <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 25 Oct 2006 06:24:03 -0700
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If we follow this kind of scope of practice that seems to adhere to the
allopathic model and only to those things that are "proven" absolutely, we
will never develop anything new because we would all be forbidden to try new
things. We would never evolve.

Or maybe we are supposed to wait for the doctors and scientists to develop
and test new ideas for us. Right.

I am almost afraid to bring this up-- but I sometimes question how we
implement the evidence-based guidelines model. I understand that we want to
be credible and not be acting out of just personal beliefs. I understand
that this is an issue even in the allopathic medical world where the
prescription for a problem can vary widely and is often not
"evidence-based."  At the same time, especially in our field, there is a
whole lot that is NOT yet pinned down, NOT yet evidence-proven. And some of
these things are going to be very hard to pin down, not to mention will take
time and money. 

Many things are "proven" and become "evidence" only after starting as
popular therapies that were studied. There are always hypotheses and
traditions to chase down. You start with an idea, see if you can support it
by any existing research, and branch out from there. Or you start with an
observation; this is how we got reglan and domperidone as galactogogues when
they were not developed as such and so are considered off-label use. 

If we cannot think outside of the box, and our box is looking smaller, we
aren't going to go very far. I have always believed in digging deeper for
answers, going beyond what we currently know, and presenting to my mothers
all the options that I know of that I think they might be interested in
(which means the choices vary from mother to mother). 

Lisa Marasco MA IBCLC

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