I don't mind all the letters in the breastfeeding soup, I just want you to
know what you are capable of spelling with yours.  Sometimes what your
letters represent are just the alphabet and the problem requires the work of
a dictionary.

 Even though I am IBCLC, there are still cases I consider beyond my scope and
I refer out. Perhaps later in my life, I will not only refer out, but
accompany to the next stop. I prefer the words "educator, specialist,
assistant" .  The problem is that the word certified is part of the IBCLC
title so it causes confusion.  I think that many that went through some form
of training are aware of their limitations, but I know that is not always the
case. ( I hear from moms who think they saw the hospitals breastfeeding
person, but did not.)  However, I would rather have a mom call LLL, a
breastfeeding specialist, educator, assistant, whatever and get information,
help and the next step she needs to take, than to have no one available
because the community only has 2 or 3 IBCLCs available.  In my area, there
are mostly hospital based IBCLC working a set schedule and unavailable
otherwise.  The few that do work private practice do not do it full time, are
not always available, or might be the only one in the county.  So, is it not
better to have resources for the "how long is my milk good for?", "my doctor
said wean because I have a fever", "my baby doesn't like my milk, he sleeps
longer with formula" and all the other questions moms have that do not
require the dictionary, only the alphabet.

As for the particular situation that started this thread, I can't see why a
person with some breastfeeding knowledge cannot answer simple questions on
the phone as long as they know red flags to watch for and don't feel they
have to know all the answers.  There is no shame in saying "you need the help
of someone much more qualified than I".  If we are talking about nurses, I
would think a nurse would know when a baby was in danger of dehydration or
the situation was more serious than they could take care of over the
phone--we are talking phone help.

As for this list, thanks to all that watch over it, thanks to all that post
to it.  Every day I learn something new and challenge myself to understand
more.  Do I know as much as this lists mothers?  No way, but someday I might.
 Until then, I am glad they offer their information and input to those that
ask.  I have never read any post here that made me feel I should have never
asked such a stupid question.  I have never read into any post an attitude
that the person asking was not qualified to be here.  This is the most kind,
supportive, informative, educational list I can imagine.  I hope those of you
who are not IBCLCs and might not even want to be know that even when you do
become IBCLC, you still have so much to learn and what you learned before is
no longer the current thinking and you will have to re-learn anyway. Even
now, what I learned 5 years ago has been replaced with new ideas and research
as changed what we believed to be true.  I am sure in another 5 years what we
learn and know today will be challenged.  That is why we need this list to
come to.  A place where the ideas are new and fresh. A place to ask a
question and get a wide variety of answers based on different knowledge
bases.  Truly, I don't just want support from my "equals", I want support
from my "superiors" and while I learn at their feet, I am just glad they are
kind enough not to step on me.  <big Smile>

Thanks,
Pam MazzellaDiBosco, IBCLC

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