Liz, I respect your opinion on many matters but I have to disagree with your suggestion that an IBCLC is more qualified to do an oral assessment than is a LLL Leader. I am wondering where you would say most IBCLCs learn how to do an oral assessment. I think that the large majority of those who pass the IBCLC exam have no idea how to do this. I think there are very few IBCLCs who go into private practice after having been mentored by someone who shows them how to do this. I feel fortunate to have been mentored by several IBCLCs at my former workplace, MilkWorks, where I was taught, over time, how to recognize oral issues, how to document them without diagnosing, where I had the ability to call on my capable colleague Dr. Kathy Leeper, IBCLC to make a more qualified assessment of whether or not a frenotomy may be helpful for a particular dyad. I also learned a great deal about oral assessment as a LLL Leader by reading the Breastfeeding Answer Book, then also reading Catherine Watson Genna's excellent text on Supporting Sucking Skills. Many LLL Leaders get continuing education by attending conferences and workshops where they may learn how to do an oral digital assessment.
IBCLCs are not a licensed profession so there is no state agency defining the scope of practice of a lactation consultant (or even who can call her/himself a lactation consultant) unlike other health professions. (For example, the list of licensed professionals in Nebraska is long, see http://dhhs.ne.gov/Pages/reg_t172.aspx, and the turf battles are ongoing but the rules and regulations for the professions are fairly narrowly defined.) So who is to say that an IBCLC can do an oral digital assessment better or worse than a LLL Leader or other mother-to-mother counselor? I agree that an IBCLC is more likely to seek out the training but certainly many LLLLs and others seek the same information and training as well.
And Laura, you asked about insurance coverage. This article in Leaven (the publication for LLL Leaders) http://www.llli.org/llleaderweb/lv/lvjanfebmar07p22.html states "The liability insurance provided to Leaders by LLLI covers work done as a volunteer with La Leche League" so the insurance coverage is not just liability insurance to cover the meeting location. However, it is important to be clear on which "hat" you're wearing as you don't want to find yourself being denied on a claim because you failed to do so.
____________________________________________
Sara Dodder Furr, MA,LLLL, IBCLC
Quality Improvement Program Specialist
DHHS - Public Health, Licensure Unit
301 Centennial Mall South Nebraska State Office Building , 3 with PO 94986
Lincoln, NE 68509
(402)471-4973 | [log in to unmask]
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Date: Tue, 10 Jan 2012 09:29:03 -0500
From: Elizabeth Brooks <[log in to unmask]>
Subject: Re: Short tongue (and) LLLL vs IBCLC scope of practice and insurance
Amy --Your post about whether an oral assessment is within the scope of practice of an LLLL highlights why one who wears both an LLLL (or ANY peer
counselor) hat, and an IBCLC hat, has to be hyper- vigilant about not sliding from one role to another.
I agree: most mother-to-mother counselors (LLL, NMAC, WIC, whomever) are NOT trained in how to do an oral digital assessment. I know I certainly wouldn't have known what to look for if I had offered an exploratory finger to a baby back in my NMAC days.
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