Hello, again, Nancy!
I know I'm over my lactnet limit, but I can't resist sharing some things
that LLL suggests in its communications skills development programs.
Maybe some of them are worth thinking about:
* it is better to give information rather than advice, suggestions
rather than recommendations. Not only does this protect the laywoman
from stepping into medical questions, but it empowers the mother and
gives her choices.
* sharing information sources, verbatim, referenced, evidence-based,
from credible sources is of great benefit. The mother needs to make her
own decisions based on that, in consultation with her hcp if it is a
medical question but, more importantly, in  consideration of her own
family. Reading from primary sources, without interpreting, gives her a
chance to "grow along the edges" of her knowledge.
* medical issues and parenting issues are not always easy to
distinguish, especially when you want to provide information as well as
support. In either case, it is fine to present credible evidence that is
consistent with the suggestions you are making if the hcp has given
out-dated information. You can truthfully say, "Well, I have a study
here that your doctor may not have read," and give the reference so that
the mother can share it with her doctor. You can also say, "Yes, I'm
familiar with that advice. You might want to consider another approach."
* hcps benefit from hearing about what mothers have tried and how it has
worked. Encourage the mother to share, and give her the support she
needs to be able to do that comfortably.
* rather than a disclaimer, consider being clear about who is making the
decisions, who is experiencing the situation etc. Validating her might
give her confidence. "You don't think the doctor's advice is helpful for
your baby. Tell me about what works with your baby." "Here are a couple
things I can think of. Do you think either of them might fit?" "Any
ideas about what might be going on?" and even, "Wow! I never even
thought of that" -- if that is genuine. (I tend to have that feeling a
lot.)
* if you feel that a doctor, nurse, LC or other hcp has given "bad"
advice or made a "wrong" call, consider the possibility that there is
something in the mother's history or situation that you are not aware
of. She may not have shared it with you, she may have misunderstood the
hcp, the hcp might know of a "confounding factor," this client might be
the exception to the rule, the best advice doesn't work in all
situations etc. It doesn't matter whether this is actually the case or
not, it is the thing you have to keep in your mind, in my opinion. It's
what I think when someone tells my child not to be afraid of his dog
because it's harmless -- well, not to my child, who has very bad
allergies! In other words, nothing is safe, harmless, or
one-size-fits-all, with the exception of: All babies need love.

Jo-Anne

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