In a message dated 11/9/2006 10:31:25 AM Eastern Standard Time,
[log in to unmask] writes:

What if the Doctors in your Hospital don't want you to Diagnose? "I don't
want you telling my patients their babies have tongue-tie. Sore
nipples are just a part of breastfeeding.'
You cannot directly contradict a doctor=B9s orders.
The IBCLC is a member of the health care team. The doctor is the team
leader. Educate, refer, but work within the team approach.
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AND:

"The bottom line is that the IBCLC (if that is her sole scope of practice) is
not medically qualified to contradict or ignore the advice of a client health
care provider. It can be a challenge to find ways to help a mother while not
contradicting her health care provider, but it can be done "
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Dear Friends:
    Well, let's rehearse such a scenario.

    LC: " I see that your nipples look like what I would call ground
beef....Oh look, your baby's tongue is heart shaped. There is something keeping the
baby from sticking her tongue out. I wonder what it could be? Your baby has to
stick her tongue out over her lower gum so nursing is comfortable for you and
she gets enough milk. Your baby can't do that. I wonder if it has to do with
her inability to stick out her tongue.

    Mother: "My doctor said that my baby is not tongue tied....and that my
nipple just have to toughen up to their new job."

    LC: The doctor always knows best. I am here to help you with
breastfeeding.
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         I didn't know that egg-walking was a standard of practice.

    warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Adjunct Faculty, Union Institute and University, Lactation Program
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com

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