I just downloaded the new Scope of Practice from IBLCE which  evidently was 
posted today -- it wasn't there yesterday, I looked.  I'll be  interested in 
what y'all think of it.  This is the part I find worthy of  discussion:
 
The following activities are outside the scope of practice of  an IBCLC:
 
--- Prescribing or recommending the use of alternative  therapies.  
        My  comment:  what is an alternative therapy?  An alternative to  
what?  Allopathic medicine?  Are we talking herbs? CST? OT? RPS?   (Hmm, Jean, 
wonder if RPS is an alternative therapy?) Infant massage?   Cabbage?  Oatmeal?  
Ice?  Cold? (for engorgement -- is one an  alternative to the other?  Are 
either an alternative?) 
    And, by the way, I find the use of the  term "many mothers have found..." 
to be just as "recommending" as  "I suggest taking ibuprophen for your 
mastitis instead of tylenol because  of the antiinflammatory effects"   
 
--- Contradicting or ignoring the advice of a client's health  care provider.
        My  comment:  Well, well, well.  The HCP tells the client to pump and 
 dump for 10 days for use of Amoxcillin.  Now, you don't want to contradict  
her -- but the advice in Hale WILL contradict her.  What to do?  How  about 
the advice to wean because the baby is lactose intolerant?  
 
--- Performing surgery or instructing others in how to perform  an invasive 
procedure.
        My  comment:  Heaven forbid we should tell a physician how to use a 
sterile  needle to open a blocked nipple pore.  Let 'em figure it out on their  
own.  It isn't in our scope of practice.  That means you can't  instruct them 
on how to clip a frenulum either.
 
Most of the rest of it is bland enough, though I'd love to  know how to 
"develop and implement a lactation management or care plan [sic]"  without being 
able to recommend the use of appropriate galactogogues or  hydrogels for sore 
nipples (alternative therapy?  Or is this  medication?  I'm not sure).
 
You are to provide evidence based information regarding the  mother's use of 
medications (OTC & prescription) while lactating:   impact on mother's milk 
supply.  Evidently you aren't required to tell her  the potential effect on the 
infant, though you are to do that with alternative  therapies.
 
Interesting that it has taken over 20 years for IBLCE to  develop this scope 
of practice.  I wonder why so long.  
 
 Jan Barger, RN, MA, IBCLC

_Lactation Education  Consultants_ 
(http://www.lactationeducationconsultants.com/)  





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