You know, most of the reason "diagnosing" is even an issue has to do with
knowledge boundaries.  There is the medical niche or circle or boundary,
within which the doctor is expected to have the best information.  And
there's the lactation niche, within which it's assumed the IBCLC has the
best information.  In a perfect world, the doctor's knowledge would extend
right up to our fence.  *He* would be spotting the thrush, since that's a
medical issue, and acting appropriately.  *He* would know how to handle
jaundice, hypoglycemia, drug questions appropriately for the breastfeeding
dyad.  But as a general rule he doesn't.

And so the mother and baby fall into an information hole unless someone
expands the boundaries of some other niche.  Medicine has been
unconscionably slow to embrace breastfeeding research as it pertains to
their field.  *We've* done it purely because *they* haven't.

I don't want to know any more about medicine than I have to.  *I'm* not the
one who should have Hale on my shelf.  I should have info on over and
undersupply, latch, nursing strikes, and so on.  But *someone* has to have
the book on his/her shelf, and if the doctors don't then I will.  I'm not
usurping their territory;  they're failing to fill it themselves.  As soon
as they do fill it - and fill it as well as I can - I'm more than happy to
give their turf back.  I never wanted it in the first place.

Diane Wiessinger, MS, IBCLC  Ithaca, NY

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