I am wholeheartedly (and under legal obligation) agree that we all need to
ask moms whether we can touch them - not only that, but during the visit I
will re-visit the question - in other words, she will have signed a
consent, but then we have talked, she has described her situation, I have
observed the baby latching (or not) to the breast.  THEN I again ask if I
can __Touch the baby __Touch her __ Hold the baby.. or whatever I think is
appropriate at the moment.

However, in Lactnet lately there has been a lot of description of the
"correct" way to be an LC, and some statements that "I would never touch"
under any circumstances...  Giving the impression that it is NEVER
appropriate to touch a baby or the mother.

As some readers of Lactnet are new and others are very experienced, some
are IBCLC's but others are from many different walks of life, I would like
to state that in my experience (IBCLC since 1985), there are times when it
was appropriate for ME to touch the baby or the mom or both.

Just as some people NEVER use nipple shields and others do, and some NEVER
use breast pumps and others do, and some NEVER use breast shells and others
do, some NEVER do a suck check and others do, this is a very personal and
professional decision not listed under the ethics of IBCLC:

#1 " Provide professional services with objectivity and with respect for
the unique needs and values of individuals.

#7 "Base her/his practice on scientific principles, current research, and
information.

#8 "Take responsibility and accept accountability for personal competence
in practice.

#9 "Recognize and exercise professional judgment within the limits of
her/his qualifications.  This principle includes seeking counsel and making
referrals to appropriate providers."

Based on my professional experience, I refer patients when it is beyond my
experience, even though it may be within the "scope of practice" of an
IBCLC .  However, in my experience with moms, some are very "kinesthetic"
in their learning - especially early in their postpartum period.  I could
talk for HOURS and not see a decent latch-on - but I can, with her
permission, help her to position her baby and her breast in such a way that
latch-on is achieved - then mom learns how to do it by herself by repeating
the process, but she now knows how it feels (It didn't hurt!)  and how to
get there (Oh, I thought he would break if I held him that way).  

I respectfully request that when statements are made about how to handle
situations, we preface it with "in my experience" so that it is clear that
what is being stated is not a "rule" that cannot be broken, but the sharing
of knowledge that others can use or not as they wish.  

(The ILCA folder refers to "The Lactation Consultant" as "A member of the
health care team"  who can "Assist" in various situations... )

Jeanette Panchula, BSW, RN, IBCLC, LLLL
Vacaville, CA
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