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Subject:
From:
"Susan E. Burger" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 18 Jan 2005 09:58:28 -0500
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First I want to address Karleen's and others who have posted similar
concerns about the differences between lay counselors and IBCLCs.  I think
that the differences in commitment towards breastfeeding are not necessarily
due to the choice of being a lay counselor and a professional than the
general background and attitudes of the person involved.  The concerns you
have raised are important ones that should be incorporated into the training
for IBCLCs.  It is not enough to look at breastfeeding as a medical issue -
it should be looked at in the entire context of societal pressures, family
pressures, and individual characteristics.  Its also not enough to look at
the problem in the moment - but how to benefit the long term relationship. A
good IBCLC should be every bit as committed to breastfeeding as any lay
counselor.  So, I would suggest that you take a look around and keep an open
mind.

I have had just as many instances of bad advice coming from well-meaning lay
counselors, pediatricians, obstetricians, family members, and baby nurses.
And in every one of those categories I've been pleasantly surprised by
wonderful advice.  The best baby nurse I saw sat up with a mom every three
hours and hand expressed (which I'm learning not everyone interprets as
using your own hand, some think its the gadget - in this case I mean
literally with their hands) five ounces of milk for her baby 8 x/day for two
solid weeks while her baby was refusing to latch.  So, I no longer prejudge
and I have to say that even some of those who I thought were hopeless when
it comes to breastfeeding advice can sometimes change.  I just scored a
major coup with Dr. Trendy who wrote a chapter denigrated LCs.  My
persistent reports to him must have paid off because parents have recently
told me that I'm on his list.  And this is after I wrote him directly to say
exactly what I thought about how he characterised us in his book.

I had a good lesson about keeping an open mind again just this last week
when I saw a horrible nipple infection without mastitis.  I'm used to moms
describing their nipples as in terrible shape over the phone, but this was
one of the worst I've seen.  The last time I saw a case this bad, the ob had
treated it over the phone without even having mom come in and it turned out
to be a complicated infection that needed very special care. I walked in for
the consultation, took one look at her nipple and told her she had to call
the breastfeeding medicine specialist we refer to right then and there. The
mom told me her obstetrician wouldn't let her see someone else without
talking it over with her.  All my prejudices about obstetrician's not really
caring or knowing how to treat complicated breast infections kicked in and I
started telling her how wonderful the breast feeding medicine specialist
was.  We called her obstetrician and she saw this mom literally 10 minutes
after we called (the office was a block away).  She did all the cultures the
breastfeeding medicine specialist would have done.  I was beside myself with
relief.  The obstetrician was just as skeptical about me as I was about her
and was relieved when the mom told her that I was the one who thought she
should be seen right away.

So, keep an open mind about those of us who are professionals.  Some of us
may be more dedicated than you think, just as that obstetrician was terrific
to my surprise.  When you find the dedicated professionals you like, refer
to them and talk to them.  It is through dialogue that we all benefit.

Best, Susan E. Burger, MHS, PhD, IBCLC

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