Kathy Eng quotes the ILCA standards of practice.  Our  interpretations are 
different.  This is not to argue that we should or  should not send a report to 
HCPs, it is to say it is not mandatory as currently  written.  Legal documents 
should not make assumptions.   On the other hand, trusting us as 
professionals to know when it is appropriate  makes perfect sense.   I do not interpret it 
to mean must.  I read "as  appropriate" to mean just that.  As appropriate. 
Who determines when it is  appropriate? As has been pointed out by several, it 
is not always  appropriate depending on the area you live as others have 
pointed out.   Having permission to share information with a health care provider 
is important  for USA LC's who cannot discuss medical information without 
consent.   However, I still feel uncomfortable with the idea that I would have to 
refuse  care to a mom who doesn't choose to allow me to share her information 
with  others---her right to privacy comes first in my mind and would make the 
"when  appropriate" mean for her, it would not be appropriate. Also, I do not 
consider  the word "communicate" to mean "report to".. The words "report to" 
also have a  variety of meanings.  It can mean simply to provide the 
information, or it  can mean 'answer to' .  I consider the ethics of my work to mean I 
'answer  to' the clients I serve.  I consider it appropriate to share 
information  when breastfeeding assistance is part of a medical situation that has  the 
potential to change the advice of the hcp or if the hcp has asked the mother  
to see me. I do not interpret appropriate to mean provide a report for  every 
phone call, email, question I answer, or even visit that is not about  a 
medical issue.  Of course, I personally do not believe breastfeeding  is a medical 
issue in every circumstance and only on the occasion that there is  a medical 
issue and breastfeeding is involved do I consider it 'appropriate' to  'share 
the information' or 'provide a report of the information shared'  or  
otherwise communicate my findings and what I shared with the mother(pick the  
semantics that works).  Otherwise, I have a consent that allows to share  the 
information, I have a consent form that states anything that I offer that is  
different from her health care providers information is for her and her hcp to  
discuss and her decision to make.  I am not working in a health care  institution.  
I think that the scope, the standards and the ethics will all  be governed by 
the place of employment also.  I do not understand the need  to take one 
method of care's rules and apply them globally and across all  practices.  This 
assumes the standard of care of the institution within the  USA is the standard 
we should hold everyone too.  Why do we not look to  other countries and model 
their standard?  Prefer we look to a country with  the highest rates of 
breastfeeding initiation and duration and model our care  for breastfeeding mothers 
and babies after that if we insist on not respecting  the differences we bring 
to the profession.
 
#3.3.7 "Document and communicate to health care providers as  
appropriate: assessment information, suggested interventions,  
instructions provided, evaluations of outcomes, modifications of plan of  
care, follow up strategies."
 
Take care,
Pam MazzellaDiBosco, IBCLC, RLC

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET email list is powered by LISTSERV (R).
There is only one LISTSERV. To learn more, visit:
http://www.lsoft.com/LISTSERV-powered.html