When my packet arrived from IBLCE yesterday, I completely ignored the
Scope of Practice. I shoved it back in the envelope to peruse later. I
wish I'd looked at it, especially since I now can't seem to find it on
IBLCE's website.
I agree with the reactions I've read thus far, in particular about
contradicting doctors. It's kind of impossible not to, sometimes; as
others have already pointed out, sometimes they are just flat wrong
(wean for TYLENOL) and the woman needs and deserves to know, for
example, what the AAP has to say about the issue (uhhh....it's
approved!) The list of potential "contradictions" with a doctor is
fairly endless, depending upon the doctor.
There IS a line that we shouldn't cross. No one disputes that. And I
for one wouldn't mind knowing for certain just where that line is, but
IBLCE has done a very poor job here of describing that line.
One is tempted to think that no one who contributed to this Scope of
Practice has ever actually PRACTICED as an LC. On what planet is it
possible never to express to a client disagreement with what a doctor
has said to her about breastfeeding? My own father, who is a
pediatrician, thought that my eldest child's bowel movements were
DIARRHEA. He actually took the child off breastmilk for 24 hours and
instructed me to give him Pedialyte. What were Matthew's stools like?
Yellow, seedy, loose, and frequent - every feeding. Yeah. Sounds like
diarrhea to me - NOT.
If a client comes to me with a similar story I am NOT supposed to tell
her that what she has described to me is the NORMAL stool of a breastfed
baby? Come on!
I also agree that the "alternative therapy" item needs to be re-written,
as it is too vague a term. What is alternative therapy? One woman's
alternative is another woman's standard of care. This is a global
profession, for crying out loud. In my current practice it's a moot
point since I work for WIC (public health) in the U.S. My clients often
can't afford any sort of medical care, much less the stuff that *isn't*
covered by the health insurance that they *don't* have. But still. For
plenty of others this is certainly an issue, and were I in private
practice I'd want to be able to send clients to other types of
professionals.
I am concerned about this. And if someone could send the direct link to
the scope of practice online I'd appreciate it. I can't find it,
although perhaps that's a good thing, LOL....
Regina Roig Lane, BS IBCLC (for whatever that's worth these days)
Senior Lactation Consultant
Miami-Dade County Health Dept WIC/Nutrition Breastfeeding Program
7785 NW 48 ST, Suite 300
Miami FL 33166
(786) 336-1333 x162
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