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From:
Borstvoedingscentrum Panta Rhei <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 14 Dec 2011 18:27:33 +0100
Content-Type:
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Absolutely not (always)! :-)

As Rachel pointed out: sometimes moms have pure breastfeeding issues that 
can be resolved by good lc care and there is then no need whatsoever to 
visit someone else.
There is absolutely no danger in working like that, provided the lc is 
capable and knows what she is talking about and refers if medical issues 
come up.
It is dangerous to say it is dangerous, because that way, we all start 
medicalizing a *normal, physiologic function*!
If I have a little bit of obstipation and I ask someone what I can do and 
that person says: "Eat more fruit and don't sit behind your computer all 
day", that is good advice.
How much better advice could lc's often give regarding the normal 
breastfeeding dyad, considering the fact lc's need to be educated properly 
and have a certificate for practicing.
I am not in danger if I don't see a gastro-enterologist for some obstipation 
and a mom and her babe are not in danger if they see an lc for engorgement 
or low production or latch problems.
With all due respect, Nancy... please, let's not medicalise breastfeeding. 
It is one of the great dangers for normal breastfeeding relationships, 
especially when it comes from our own ranks.
It also makes healthcare in general unaffordable; that way, whole sections 
of the population end up uninsured, which is considered inhumane here in the 
Netherlands.
The way societies are organised, certainly influences the way healthcare is 
organised. Exaggerated liability issues are also a thing to consider in this 
respect.
Once you think you can order life the way you want it to be and if it turns 
out different, you can sue someone who's fault it is... happiness gets a 
whole new meaning.
I'm not a communist, but there are many options between complete state 
control/solidarity and complete liberalism/own responsibility.
Society as a whole plays a role in breastfeeding habits and breastfeeding 
commitments. What was it again...? "It takes a village/society to raise a 
child."

Best,

Marianne Vanderveen-Kolkena IBCLC, Netherlands


-----Oorspronkelijk bericht----- 
From: [log in to unmask]
Sent: Wednesday, December 14, 2011 4:34 PM
To: [log in to unmask]
Subject: Re: Multiple caretakers

Absolutely!

-----Original Message-----
From: Lactation Information and Discussion 
[mailto:[log in to unmask]] On Behalf Of [log in to unmask]
Sent: Monday, December 12, 2011 11:11 PM
Subject: Multiple caretakers

Seeing multiple health care providers/allied health care  providers without
any communication or coordination is dangerous.   That is why the AAP is so
concerned with the concept of "medical home".  We  should all be talking
with each other as a team for the patient's benefit.   In the USA, the 
leader
of the team and coordinator of care, meds, etc. is the  physician.

Nancy
Nancy E. Wight MD, IBCLC, FABM,  FAAP
Neonatologist

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