I'm not aware that there is any imperative on IBCLCs to send anything at all
to another health professional who has a relationship to a mother or child we
might help.  Certainly it is useful in many cases.  In the case Amy reports, I
agree it seems the midwife lacks up to date knowledge on normal parameters for
BF babies.  On the other hand, she seems to realize it, in that she refers to
Amy when there is a problem.  With that as a starting point - the midwife and
Amy agree that there is a problem and that Amy's knowledge is desireable - I
would give the midwife some feedback privately, after the fact, along the
lines of 'I wonder if I am mis-reading you.  I felt that you disagreed with my
assessment, and that it bothered you.  Could we talk about this?'  Or maybe
just thanking her for the referral and the opportunity to collaborate to the
benefit of the mother and baby in question would be a good start.
Maybe she is resistant to updated knowledge.  For some reason she is doing the
right thing anyway, by referring.  Grasp that thread and work from there.

One other thing - I couldn't find Amy's full name in the original post.  Since
there are several Amys on Lactnet it would be helpful for the rest of us if
each of them consistently identified herself fully when posting.

Rachel Myr
midwife who likes to stay updated on BF, but who knows not all midwives are
like that.  *sigh*
Kristiansand, Norway

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