Meg,
I would be interested to read the responses to your questions, as well.
I am also a non-hcp IBCLC, but since I don't have a private practice as
yet I am going to put my volunteer hat for a moment. My practice is to
read the entire citation from Hale to the mother, including the code and
the key to the code for safety. I make sure I do not say a drug is safe
or not safe for breastfeeding mothers, and tell the mother I can't say
whether it is safe or unsafe for her and her baby. If asked why I can't,
I explain that I don't have the medical background that would help me
take a complete history. I usually tell the mother before I start that I
will be reading information from this source -- with complete reference
-- and that I would be happy to provide her doctor with the same
information, if s/he didn't have that particular book on hand, since it
is the one most hcps recommend. I tell her that if she would like more
information herself, I am happy to do some research and ask my resource
people.
I also offer to give the mother suggestions to talk to her MD about
contradictory (I don't say inaccurate) information, for instance, by
affirming that breastfeeding is important to her, and that she would
like the doctor to discuss options with her -- delaying, finding an
alternative treatment, etc. Occasionally, I've had a mother rehearse
what has been a difficult situation for her, and in all cases I make
sure that I support her in her own decisions. In other words, if she
chooses to "comply" rather than "resist", I can certainly understand
that she has her own reasons for doing so. Over the years, in fact, the
reasons are less mysterious to me!
Again, this is a volunteer LC, rather than an IBCLC-in-practice,
speaking, and I'm eager to hear how others deal with this question.
Jo-Anne Elder-Gomes, IBCLC on the fringes of allied health care
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