>Speaking of ethical dilemmas: what to do when you have discovered that
>ankeloglossia (sp?) is causing a baby's persistent latch difficulties (or
>mother's persistent pain) but the pediatrician has told her that frenotomy is
>unnecessary, that the fremulum will "stretch" or some other nonsense, and you
>happen to know of an ENT who will do the procedure?
Is it because I'm not an RN? I've never seen a problem with any of these
recent discussions. I see it as my job to inform the mother of her choices,
to give a professional opinion on which choices I suspect would be most
helpful, and to help her implement any of the choices that she likes.
I usually give tongue-tie moms all the pertinent articles out of JHL 6(3)
1990 (*Wonderful* issue!) and Alison Hazelbaker's Assessment Tool (we
usually work through it together, which gives the mom an even better
understanding of what's going on), and discuss the pros and cons of various
actions. I also have a sheet listing all the tongue-ties I've worked with,
their various decisions and outcomes. If I know her ped to be one who
doesn't snip, I give her a list of people who will, and their prices.
I've never seen this - or domperidone or anything else - as any more of an
ethical dilemma than seeing someone with a bald tire whose favorite mechanic
hasn't commented on it. Why would I hesitate to tell her about some good
tire shops where she could have it checked? Because her *mechanic* wouldn't
want me to??
(I loved it when I heard a reporter with breast cancer say she didn't like
her first oncology team, "so I fired them." The phrase startled me, then I
realized it was exactly right. Health care professionals are simply
employees a mother has hired. They have no rights whatsoever over her, and
they don't dictate what she's allowed to learn or where she's allowed to
learn it.)
If I worked in a hospital and had job-related restrictions, I suppose my
strategy would be to refer a mom to an independent LC who I knew would feel
utterly free to offer information and options. And I wouldn't hesitate to
talk "in general terms" to that LC to prime her for a certain mother
calling. Hey, no names would be mentioned, right? I'd just be asking
questions like, "What would you do if a mother called who..."
--
Diane Wiessinger, MS, IBCLC Ithaca, NY
www.wiessinger.baka.com
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