I would like to know what other PPLC's do about sending reports on follow
up phone calls, or phone calls from clients.  Do you only send reports to
the HCP when you take on a client - or actually see them, or do you send
one with every contact (direct visit and phone call, email) you have with
her?

Example: (conditions have been changed)  A mom called 3 weeks ago and
asked for initial consult for jaundice.  I went to her home, did my
initial history/physical exam and observed 2 feedings.  We discussed
possible low supply and worked on latch, and saw a obvious improvement in
milk transfer.  I sent a report to the baby's Pedi, and mom  followed up
with her Pedi as directed by his staff, and the jaundice was resolving.  I
did a follow up phone call a week later,and learned that the jaundice
indeed had totally resolved.  I did not send another report to the Pedi,
as the condition had resolved, and only old information was reviewed.
Fast forward to today.  Mom calls me and states that she thought that
after wearing an underwire bra mid-week, she had the beginning of
mastitis.  Mom spoke with her OB towards the end of the week, was going to
be seen, but then the symptoms went away, and she canceled her appt.  She
was concerned about the reduction in her milk supply from the mastitis,
and called me about the perceived low milk supply.  During this 10 minute
phone call, we reviewed the same things that we discussed about earlier
with low supply, pumping, but also discussed the signs of mastitis and the
importance of seeing an MD if they returned, as well as the importance of
continuing bf during mastitis and other typical actions to take.  We also
discussed Reglan (which the MD had offered due to the decreased milk
supply) at mom's request of info.

Would you send a report to her OB on this phone call?  I feel confident
that this educated, second time bf mom will return to her OB for follow up
care as needed, as well as for the reglan.  Would you have answered her
questions over the phone, or would you have told her to set up a follow up
LC appointment?  If you would have scheduled an appt, how would you say
this?  I know that I don't want to get into doing "phone consults" as they
take time that is not billable, nor can you see the big picture, but
sometimes they just need a little information.  I don't want clients to
think that I just want to come back for a follow up visit for the money,
but on the other hand, since I can't perscribe antibiotics would it be
better to give her information and tell her to contact her to her OB for
an evaluation of the condition that she perceives is resolved?

I would love to hear how others handle these types of situations.

Thanks in advance,
Brenda Dalton RNC IBCLC
NW Louisiana USA

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