I have a bit of a biased answer to your question regarding PA's ability to
handle lactation related issues.
I have been a board-certified PA for 10 years, and have recertified once by
exam. I went to a very highly respected, medical-school based program that
has been around since the beginning of PA history. I also specialized in
pediatrics, so my answer is biased in that regard.
While in my training, we (PA students) took several modules on
breastfeeding, including a full day breastfeeding program given to us by Dr.
Marianne Neifert ("Dr. Mom"). I spent months in the NICU and newborn
nursery, as well as in pediatric offices durning my internship (in addition
to regular internal medicine, OB/GYN, emergency medicine, general surgery,
and the like - I don't want you to think I only learned pediatrics).
Anyway, to make a long story somewhat shorter, I feel that I was as well
trained as a medical program would allow, and would put my breastfeeding
knowledge upon graduating with any physician's. Now... Was that enough?
No, of course not. We all know that most physician's knowledge of
breastfeeding issues is often woefully lacking. As I went to work through
the years, I realized a knowledge deficit on my part - and took appropriate
continuing education to improve my breastfeeding knowledge. I eventually
became a Certified Breastfeeding Educator, LLL Leader, and IBCLC, because it
became a passion with me after the birth and extended breastfeeding
relationship with my own children.
As an intern in the nursery/NICU, I was also made (yes, made) to attend
luncheons put on by pharmaceutical companies - especially including
artificial baby milk talks. I learned about the ingredients, number of
calories an ounce, what was available for premies, high calorie ABM's, human
milk fortifiers, and alternatives available such as elemental formulas.
That knowledge has also proved invaluable over the years, although I think
it should have been done without the food and "free" stuff.
The important thing for PA's, MD's, RN's, IBCLC's, or anyone, is to know
when you don't know something, and when to refer to someone who does. You
also need to know your community resources to know WHO to refer to. And
when you find something that you don't know, you LEARN about it. My
education didn't end on taking the board exams, it began.
So what is your answer? In short, I believe PA's are as well trained as
any other primary health care provider in BASIC breastfeeding issues
(assuming that they went to a good school). No more so, and no less.
I hope this helps you answer your question, and feel free to email me
off-list if you want to talk about it.
Gentlebirthing AT msn DOT com.
Tara Guy
Tara Guy, MPAS, CHA/PA-C, HBCE, IBCLC
www.rockymountainbaby.com
helping mothers birth and parent from the heart
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