> ...If I were certain that the answer
> to your question is, "Of course, IBCLCs, this SOP does NOT preclude you
> from offering up-to-date research and guidelines" then I would not have
> a problem with this SOP. 


The SOP refers EXPLICITLY to the provision of evidence-based info several times. (And before I jump into the discussion, I want to clearly state that I had NO role in the development of IBLCE's SOP!) I think discussion of the IBLCE SOP posted last year has become sooooo focused on a couple of points under "outside the scope of practice for the IBCLC" re: "contradicting or ignoring the advice of the client's health care provider" and possibly the line re: "prescribing or recommending the use of alternative therapies" that the rest (and well-stated points) of the document is/are being ignored. IMHO by ignoring the statements preceding these, especially re: "Preamble" and then "IBCLCs are able to," the points under "outside the SOP" become out of context, and the SOP "baby" is being thrown out with the bathwater.

In the preamble the SOP explicitly states "...the (IBCLC) role incorporates: Provision of holistic, evidence based lactation support and care...from preconception to the end of the lactational cycle," "Education..." (statement includes all of society re: BF/lactation), "Advocacy for BF women..." (statement includes involvement in activities for social/policy change). The preamble goes on to state that the IBCLC role is an autonomous one re: "...may work independently or as part of a health care team..." (within a HC system), yet autonomy includes responsibility so included is a statement re: (IBCLC) "works collaboratively with health care providers..." (includes broader HC team).

Under the "IBCLC is required to," the SOP explicitly states the IBCLC must (among several points) "...provide evidence based information regarding the mother's use of medications..." (includes OTC and px), "provide evidence based information regarding alternative therapies while lactating..." (then refers to inclusion of potential effects for the BF dyad)."

Because as an IBCLC I am obligated/required to provide evidence-based info, which I believe includes distinguishing evidence from theory from anecdote, the info I offer may at times contradict that of the dyad's healthcare provider(s). But the evidence can speak for itself; I don't need to directly contradict the HCP. For example, if a pedi suggests AIM is about as good and not problem with supplementing, I can offer the mother (and the pedi when applicable) evidence-based information re: science of human milk properties vs. AIM and principles of lactogenesis (vis-a-vis effect of supplementation) and refer to pedi's own professional organization's position on BF/human milk. As part of my required advocacy role, I can speak directly to the pedi about the evidence and/or I provide the mother with info about using evidence (or requesting such for any HCP's recommendations that may affect the dyad) to positively confront other HCPs p.r.n. 

All of the above enable me to fulfill what I am required to do within the SOP of an IBCLC without violating what is considered outside of the SOP for IBCLCs.

Although I believe the points of contention re: "outside the SOP" posted last fall on IBLCE could be better stated (and could be interpreted as contradicting earlier preamble and "required" points), I would encourage discussion of the document in the context of it as a whole/entire document. 

Thanks for letting me get in my 2 cents...

Karen G

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