Karen is so right in asking:

Did you hear this from the IBCLC in question or from the mom?  Much of what
I'm told an IBCLC told a mom is often what she CHOSE to HEAR...such as "let
the baby sleep" might have been...IF your baby is
wetting...stooling...gaining weight THEN you can let the baby sleep xx hours
(in terms of newborns).

I'll never forget when I was told that one of the people I had trained had
told a mom whose breast was exceedingly engorged (later on we found there
were actually no ducts to the nipple area - but I was hearing this on the
phone), to USE A NEEDLE to MAKE an opening.  (It turned out to have been a
"friend" who told her - who has an unusual name...as does the staffer I
trained.)

Another question is: could it have been that that WAS the right choice based
on the situation at the time, but NOW it would NOT be the right choice?
This happens a lot to me, as I see moms on day 4 - 5, and they tell me what
the LC or nurse told her in the hospital - now I see an alert baby, a breast
brimming with milk and what I do/recommend is very different from what the
person that only had her for 24 hours immediately postpartum.

However, I have also had the opportunity to educate people who have been
"singing the same song" for a little too long...without updates.  Just last
Friday I used a slide that I use to show the evolution of breastfeeding
promotion from when I started (70's when we used to say: it's a lifestyle
choice) to the 80's, 90's and now - evolving to a public health issue - to
also show that I would NEVER teach the same information (positioning, nipple
preparation, etc.) and how important keeping up with information is.

In a group situation, if you possibly can do it, may be much less
threatening and effective. In fact, some of the nurses in a local hospital
created a program with the approval of the nursing supervisor that was
required for all staff to attend - many had never had formal breastfeeding
training (another reason to push for the rule that all staff that work with
mothers and babies should have AT LEAST xxx hours / year of training on BF.


However, we are going to be required to know what are the Ethical
requirements of our profession - and if the IBCLC is in fact giving
incorrect information and refusing to change it despite evidence based
research, then we need to follow the procedures of IBLCE.
www.iblce.org has a great question/answer section on ethics with responses
to very specific situations.

Jeanette Panchula, BSW, RN, PHN, IBCLC, RLS

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