Hi everyone.  This happened to me lately.  I'll try to make it brief, but
would appreciate any suggestions or comments regarding the situation.  I
received a call from a hospital LC requesting that I see a patient of hers.
 The hosp. LC was out that week and unable to deal with this mother who
insisted on getting an SNS, and needed help starting to use it in the NICU.

     It was the mother's understanding that I would be paid my consult fee
for this service, and I was to assist her with this on Wed. a.m.  I received
a call from the mother that morning saying that pediatician was concerned
about breastmilk jaundice, and that we would need to delay my visit.  (<This
is another story that I need not delve into because we've all heard stories
like this before.)

     Fri. afternoon the mother calls and says that she has spoken to her LLL
Leader, and if it's okay by me, she'll purchase SNS from me, and her LLL
Leader will help her use it in the hospital for FREE.  (Evidentally, the
Leader is not part of the Medela BASP program, or she probably would have
offered to sell her the SNS as well.)

     It is important to note that this LLL Leader is a nurse and an LC in her
own right.  There is no doubt that she is capable of assisting this mother.
 Also, I was unaware that this mother had attended LLL Meetings since the 9th
week of pregnancy, and that she was in the hospital with preclampsia for a
month prior to the baby's birth.  I did know that baby was still in hospital,
3 weeks post-partum with a g-tube.

     The mother never complained about my fee with me.  However, she did
complain to this LLL Leader who felt impelled to assist her.  The mother did
not ask her for this help, the LLL Leader offered it to her.

     The Leader works full time during the week and was willing to drive 35
minutes to the hospital, help this mom, and drive 35 minutes back home during
the weekend.  She offered her Leader service to this mother without calling
to inform me that she was, in essence, cancelling my lactation consult and
fee!!!

      I felt very uncomfortable about this whole situation.  I was not
willing to just sell my SNS, and have this Leader handle it.  The hospital LC
referred this responsibility to me, and even though this Leader is fully
qualified, I did not want the hospital LC to be angry about someone else
coming in to work with this mother in NICU.  At the same time, this mother
needed the assistance, and had a FREE offer from a qualified professional.

      So I worked this out by selling the SNS to the mother and waiving the
consult fee.  I live a 1/2 block away from the hospital, and it was
rediculous for this Leader to drive in. Another part of my rationale was that
this is a service that should have been offered by the hospital, and because
they are too cheap to hire more than one LC, LC services are practically
non-existent when she is gone.  Oddly enough, this hospital signed a
committment to be Baby Friendly???

      When I finished this consult, I let the Leader know about her progress.
 I also asked her to, "please never do this to me again".  What bothers me is
that Leader  felt that she was acting within her rights as a Leader to
provide a home visit to this mother, and does not feel as though she has done
anything wrong.

      I need to know what YOU think.  Should a Leader be able to provide a
home visit in the hospital assuming that she has the same credentials as the
hospital LC?  As she put it, "this mother has attended a number of LLL
Meetings, she is a paying member, and she has a right to the services
provided by La Leche League".

     Before anyone thinks that I am an LLL basher, I want you to be aware of
the fact that I am also an active LLL Leader, and I hold two positiions on my
Area Council.  I LLLove LLLeague, but I definitely felt wronged in this
situation.  Please let me know what you think...          Debbie Albert,
Ph.D., IBCLC