In a message dated 4/10/04 1:38:00 AM Eastern Daylight Time, [log in to unmask]
writes:
I would like to enhance this duscussion to other sub-optimal practices of
fellow IBCLC's giving definitely wrong advise, like advice that is not
consistent
with current lactation knowledge, evidence based lactation practice, etc.
I rather often hear of thes kind of things and would like to know if I
could/should undertake action and if yes: how or what.
I fear for a devaluation of the image if the lactation consultant profession
when giving suboptimal or even wrong advice is getting more and more the case.

This is an interesting topic. I would think some of this would depend on
whether we are hearing the IBCLC in question giving the advice firsthand
(directly) or second hand (via a mother, colleague, etc.) or even third hand. If
firsthand, did we initially confront the IBCLC with evidence that clearly refutes
the advice she gave so she could alter her practices? Did subsequent firsthand
observation reveal that the IBCLC in question did not alter practice re:
evidence-based info.  Since much of what we do is still lacking in evidence or
strong research evidence based on large samples and/or true quantitative data, do
we provide organizational or local forums to discuss cases and share different
approaches based on theory or available research -- and does the IBCLC in
question avail herself of such forums? And, finally, if the info is second or
third hand, can we assume to know if it was relayed accurately or in its entirety?
Is it our place to move forward or the person who relayed the info?

Then there is the whole question of what comprises "suboptimal" from
"standard" of practice (lowest acceptable level or grade C -- passing but average)
from "optimal" when so much of what we do involves art as well as science? (The
different approaches often offered by Lactnet members is an example.) We're
gaining more science but there still is a long way to go...

You've asked a complex question!

Karen

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