Every IBCLC, everywhere, should have at her fingertips -- and have recently
read -- the IBLCE Code of Professional Conduct, the IBLCE Scope of
Practice, IBLCE Clinical Guidelines, and the ILCA Standards of Practice.
 For good measure I'd throw in the ILCA Position Paper on the Role and
Impact of the IBCLC.  All are readily downloaded from the IBLCE and ILCA
websites.

Quit groaning.  I am talking about a grand total of about 12 pages here.
 Just Do It.

We are a newish profession (29th year now ...) and most folks (mothers,
hospital administrators, insurance companies, public health regulators)
have no idea what an IBCLC is, or does, compared to Other Breastfeeding
Helpers.  And as between you (the IBCLC) and them, I'd argue the burden is
on the IBCLC to "prove" (and market) herself.

We are often challenged on what our role is, as an allied healthcare
provider with skilled lactation expertise, as part of the healthcare team.
 Sometimes it comes from generalized misinformation or misunderstanding
("How are you any different from a peer counselor?") and sometimes it comes
from workplace power-plays and bullying ("You can't assess tongues on
breastfeeding babies.  That is outside your scope!").

The specific answer to what IBCLCs can "do" vis-a-vis ankyloglossia is:
Provide an assessment, and evidence-based information and support, until we
are blue in the face.  We assess -- we don't diagnose.  We offer
information the family can discuss **with the primary healthcare
provider,** because the family is entitled to make a fully-informed
decision about the health of the mother and child. (Which of course has
life-long morbidity implications.) But we don't "tell" a family what to do.

Now -- that being said -- going toe-to-toe with a superior (in terms of
pay, prestige, power position, etc), at the workplace, is a very delicate
thing.  There are many IBCLCs under "gag orders" not to discuss tongue
function during breastfeeding, which is almost laughable when you think
about it. Until and unless they can effect change internally (which often
takes MONTHS and a LOT of diplomacy), they must respect the gag order in
order to keep their jobs.  But it is not supported on the documents
evidencing our scope and skill that this is "beyond" what an IBCLC can "do."


-- 
Liz Brooks, JD, IBCLC, FILCA
Wyndmoor, PA, USA
IBCLCs empower women and save babies' lives!
Learn more <http://tinyurl.com/3nj2p3c> and visit www.ILCA.org

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