Pamela,

I think what you have described sounds like a very clear way to work within the
health care system, which is where LCs are located.  You have made it explicit
to women what you are doing (not all HCPs do this) and with whom  you will
consult.

What I was picking up on was the different relationship of the hospital to the
LLLLs you reported in your original post.  As I said, I am not familiar with
their code of conduct and working practices -- any LLLLs want to comment? -- but
was pointing out that the lay organisations I have worked for in the UK have
based our codes of conduct more on the models used in counselling bodies (in our
case we look to the British Association of Counselling, which, in turn, is
guided by EC regualtions and practice in the area).  This is a different model
with different explicit aims.  I wondered if the confidentiality which is our
working practice was part of the difficulty in terms of these LLL workers coming
into hospital.

I know that LCs work in a different way to lay breastfeeding supporters, and I
don't have a problem with that, although I think it would be great if everyone
concerned understood the differences.  It took me a while to work the whole
thing out, (so probably I have some of it wrong!) but I know in the UK  LCs are
very thin on the ground and low profile (do we have one or two in private
practice in the country???)  so few have heard of them.  Lay breastfeeding
supporters are still very poorly understood by health workers and by women
before they come into contact.  This confidentiality aspect always seems to
puzzle HCPs when I work with them, so I thought the same might be true for your
local LLLLs.

For the record:  we put confidentiality so high BECAUSE we are outside the
health service and provide a safe place for women to come with their issues
about breastfeeding.  One of the most fundemental reasons for lay organisations
to exist is to have a place to address some of the iatrogenic --i.e. caused by
the health care system -- difficulties women experience with breastfeeding.

We do a different job from LCs although our work overlaps a lot.  Hence the need
for different ways of working.

It would be interesting to hear what you, and anyone else, thinks of these
different models, and how we can better understand the ways each sort of
breastfeeding worker works.

Magda

Magda Sachs
Breastfeeding Supporter
The Breastfeeding Network
Uppermill, Saddleworth, near Oldham, UK