Hi All,
I am reading this thread with great interest and would like to respond to a
few things...First my comments:  Train wrecks should not be happening with
IBCLC's.  There is thing called ethics and knowledge that one does not know
it all.  Sadly, I see many times where some other LC misses something that,
in reality, they should not have missed because it was basic entry-level
observations that should have occurred and did not.  The other thing is when
someone does a consult knowing they are out of their skill level and DOES
NOT REFER OUT!  Yes I am shouting!  If I find myself in such a situation who
the heck am I to use this dyad as guinea pigs??  I refer out, telling the
mom exactly WHY, and ask if I can follow along to learn with her.  There
should be NO territorialism at all - we should be working together, right?  

The moms who are in the middle of these train wrecks (who do actually come
to me) do so by the encouragement of friends or family or Dr. and are
usually under the impression that THEY are the ones at fault and how
relieved they are to find out it isn't them...then the anger at the
situation of "Well, why didn't the 'LC' (who may or may not be IBCLC) at the
hospital see what you are seeing - or know this information?"  Jennifer Tow
is correct - these moms need a LOT of hand-holding and TLC and it my time
that is used that I have yet to charge for.  I only charge for the time I
spend in their homes...I spend hours on the phone with them encouraging,
counseling, etc.  That is my job...and I love it.


Jennifer also writes:

I am with you-- I cannot bear the thoguht of seeing one more tongue-tie this
month that other LCs missed ( moms were told they had flat nipples and given
nipple shields!!) or one more baby whose structural restrictions from birth
trauma literally prevernt him from going into extension (or flexion,
depending on the trauma) and achieving a proper latch. I am truly fed up.
IMO, these ought to be basic assessement skills and I don't think the test
evaluates for them in any way.


Jaye here:  I agree whole heartedly!  How many tongue-ties were missed - how
many babies whose heads were so slanted off to one side due to forceps or
vacuum that they couldn't open their jaws symmetrically and BF effectively,
babies whose cranial bones were seriously overlapping due to TIGHT muscles
bc of vacuum, C-1 issues, broken collar bones (I caught one just a few
months ago - baby was 10 days old!), and the worst for me, is the babies
whose suck is dysfunctional (due to above issues AND labor meds)to the point
of not being able to BF and having difficulty even bottle feeding - the jaws
are so tight - the tongue is not lifting or moving properly and I have NO
ONE to send them to for proper treatment and I am not certified (YET!) in
treating them.  While I understand some of this cannot be caught on day 1 -
most can.  And the parents just want to know why those people at the hosp
didn't see it.  I feel that some, if not all, of these issues need to be
addressed in a higher skill level.  We, as professionals need to educating
ourselves more and more just to be able to deal with, and understand the
more serious issues we are running into.  And most of all, we need to NOT be
afraid to refer out to those with more education or experience than
ourselves.  

Yours in frustration (and lack of $$ to get the training I desperately want
and need...)
Jaye Simpson, IBCLC
Sacramento, CA

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