Since we have been discussing the exam lately, as well as what journals a
lactation consultant should read and whether it is necessary to belong to
ILCA, I've been thinking of a related issue I feel strongly about.  I think
it is more important to know where to find good information than it is to
memorize all the possible diseases that might affect lactation or every
medication and what its effect will be on the lactating mother and baby.  I
happen to think that the Journal of Human Lactation, Riordan and Auerbach's
Breastfeeding and Human Lactation, Mohrbacher and Stock's Breastfeeding
Answer Book, Lawrence's Breastfeeding: A Guide for the Medical Profession,
and a current copy of Hale's Medications and Mothers' Milk have all been
extremely useful to me in quickly finding answers to questions.  So has the
Lactation Consultant Series.  Breastfeeding Abstracts helps us know about
current studies so that we can look at those that relate to our practice.
I worry about people who give breastfeeding advice who are not familiar
with these basic references in the field.  (Of course there are many
others. I myself am not familiar with the Australian resources and know I
should be.  And it often may be necessary to go to a health sciences
library to search in further depth on a specific topic.)  Even if we could
memorize all the information relating to medications and breastfeeding, or
illness and breastfeeding, so much changes from year to year that we must
have a way to keep updating our information.  I would rather see exam
questions ask which resources a LC could reasonably consult for a specific
concern, rather than which medication is considered safe or not safe while
breastfeeding.  By the way, La Leche League leaders have access to these
resources through a hierarchy of Area Professional Liason leaders who can
look up and provide the information for less common and more difficult
situations.  The APL in turn has access to more specialized experts on the
national and international level.

When we talk of helping prospective LCs who cannot afford to attend
conferences, we should also work to make available basic resources at the
local level.  I wish every pediatric practice could have The Breastfeeding
Answer Book by the phone.  A few years ago I made up a list of resources
for Wisconsin nurses who want to become more informed about breastfeeding.
I think we need to help newcomers to the field know where to start and what
basic references to have at hand.  Any of the major lactation courses will
probably give them this information, but it takes a while for people to
find their way to them.

Anne Altshuler, RN, MS, IBCLC and LLL leader in Madison, WI
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