Dear Melissa, Welcome to the world of the LC. I don't envy you the road ahead (beginning LC services in a typical hosp setting) which can be quite difficult to navigate. Reading your post, there are multiple issues one could explore (incorrect advice to a pt post breast reduction, probable primary lactation insufficiency, donor milk availability, financial and equipment constraints of the moms, and scope of practice issues). I'll share some thoughts with you. You ask "My question is: 1. Can I recommend a herb/drug and, or, the dose/strength of a herb/drug to a client without risk of penalty or loss of my nursing license?" My answer would be "that is open to interpretation." There are quite a no. of posts in our archives which debate this very issue. Refer to your standards of practice and ethics and your nsg standards of practice since you are probably hired as an RN there. My main recommendation in regards to these types of situations is to be very careful. It takes awhile usually (years) to gain respect from the docs and other staff. You cannot function solo, esp. in a hospital practice, so you have to have collegial relationships. *Share information* with the docs and the parents. Try not to get too upset if a doc does not proceed w/ your recommendations. It takes time. You have to prove yourself. Over time, most LCs become trusted, respected colleagues and get referrals from the very docs and staff that looked at them suspiciously years before. (There can be one or two holdouts too, but that's another story - don't sweat it.) Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA *********************************************** 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 mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html