Jan, I fully agree with you that these paragraphs need rethinking a lot.
I don't think I could do a honest job as a LC without informing moms about all avaiable alternative options as possible treatment for her condition, or without being able to correct false advise by any not very well up-to-date HCP
Warmly,
Gonneke, IBCLC, LLLL in southern Netherlands, preparing for a reunion next saturday for LLLleaders in our Area, celebrating 30 years of LLL here and 50 years International.
[log in to unmask] wrote:
I just downloaded the new Scope of Practice from IBLCE which evidently was
posted today -- it wasn't there yesterday, I looked. I'll be interested in
what y'all think of it. This is the part I find worthy of discussion:
The following activities are outside the scope of practice of an IBCLC:
--- Prescribing or recommending the use of alternative therapies.
My comment: what is an alternative therapy? An alternative to
what? Allopathic medicine? Are we talking herbs? CST? OT? RPS? (Hmm, Jean,
wonder if RPS is an alternative therapy?) Infant massage? Cabbage? Oatmeal?
Ice? Cold? (for engorgement -- is one an alternative to the other? Are
either an alternative?)
And, by the way, I find the use of the term "many mothers have found..."
to be just as "recommending" as "I suggest taking ibuprophen for your
mastitis instead of tylenol because of the antiinflammatory effects"
--- Contradicting or ignoring the advice of a client's health care provider.
My comment: Well, well, well. The HCP tells the client to pump and
dump for 10 days for use of Amoxcillin. Now, you don't want to contradict
her -- but the advice in Hale WILL contradict her. What to do? How about
the advice to wean because the baby is lactose intolerant?
--- Performing surgery or instructing others in how to perform an invasive
procedure.
My comment: Heaven forbid we should tell a physician how to use a
sterile needle to open a blocked nipple pore. Let 'em figure it out on their
own. It isn't in our scope of practice. That means you can't instruct them
on how to clip a frenulum either.
Most of the rest of it is bland enough, though I'd love to know how to
"develop and implement a lactation management or care plan [sic]" without being
able to recommend the use of appropriate galactogogues or hydrogels for sore
nipples (alternative therapy? Or is this medication? I'm not sure).
You are to provide evidence based information regarding the mother's use of
medications (OTC & prescription) while lactating: impact on mother's milk
supply. Evidently you aren't required to tell her the potential effect on the
infant, though you are to do that with alternative therapies.
Interesting that it has taken over 20 years for IBLCE to develop this scope
of practice. I wonder why so long.
Jan Barger, RN, MA, IBCLC
_Lactation Education Consultants_
(http://www.lactationeducationconsultants.com/)
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