Dear all,

For quite some time now, I've been struggling with a very important issue. I have a serious question and would like you to think along with me and try and give me well-thought through, serious answers. Here we go.
This year April, through this list we were all informed about the new Scope of Practice. I seem to remember that the common opinion was, that the document was a real improvement, especially because it no longer specified what *could* be part of the lactation consultant profession, but what *should* entail practicing as such. Adhering to the Scope thereby means: clearer descriptions of the tasks of the lc *and* better services to the general public, because the document clearly points out that breastfeeding support is not only about the right latching techniques, but to a great extent about social, cultural, psychological and emotional aspects.
For example, it says: IBCLCs have the *duty* to protect, promote and support breastfeeding by:
- facilitating the development of policies which protect, promote and support breastfeeding;
- acting as an advocate for breastfeeding as the child-feeding norm;
- providing holistic, evidence-based breastfeeding support and care, from preconception to weaning, for women and their families (holistic meaning that characteristics of a system cannot be explained by simply just taking the sum of its components, or more simple: in essence, all things are connected and indissoluble);

The Scope goes on with: IBCLCs have the *duty* to provide competent services for mothers and families by:
- integrating cultural, psychosocial and nutritional aspects of breastfeeding;
- providing support and encouragement to enable mothers to successfully meet their breastfeeding goals;
- using the principles of family-centered care while maintaining a collaborative, supportive relationship with clients.

And: IBCLCs have the duty to act with reasonable diligence by:
- working collaboratively and interdependently with other memebers of the health care team;
- reporting to IBLCE any other IBCLC who is functioning outside this Scope of Practice.

The SoP starts with referring to the Code of Ethics; there is a duty to uphold its standards, as well as those of the ILCA Standards of Practice.

Considering all this, what would you think, say and/or do, when a group of influential IBCLCs says that lc's should restrict themselves to breastfeeding (in which bonding, attachment, baby behaviour, parental expectations about babies and interaction with newborns are *not*, repeat *not* part of the lc profession) and is thereby hindering the process of preventing the introduction of national guidelines for young child health care, that promote letting baby cry it out, stretching feeding schedules, restricting interaction to certain moments of the day, leave baby to play on its own because of the perceived need for independence at the age of a couple of weeks and defining short periods of sleep, frequent breastfeedings and regularly waking up as problem behaviour?
I hope you are willing to abundantly share your opinions with me on this one. I'm having extreme difficulty getting the meaning of the extensiveness of our (at least *my*!) profession across... :-(

Warmly,

Marianne Vanderveen, Netherlands

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