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Subject:
From:
Elizabeth Brooks <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 7 Jul 2018 06:22:31 -0400
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Ahh, I do love parsing language.  It's the lawyer in me.

Frank Nice persuasively argues that anybody (including IBCLCs) can
"recommend" over-the-counter (OTCs) or other non-prescription drugs and
remedies, precisely because they are merely recommending.

I had earlier suggested that IBCLCs canNOT "recommend" OTCs under the IBLCE
Scope of Practice and Advisory Opinion on Assessment Diagnosis and Referral
because those practice-guiding documents broadly interpret the idea of
"medical **treatment**" and a recommendation can be construed to be a
"prescription" or "order".

But I think we are on the same page.  It all hinges on that word
"recommend."

IBCLCs DO need to be wary when they stray into territory where it appears
to the lactating parent that the IBCLC has said they should/must/have to
take a certain drug. IBCLCs are NOT the primary heath care providers (HCPs)
and there may be something in the parent's history about which we are
unaware (cuz we aren't the HCP ....) that would make use of that item. When
we are working with parents with early BFg issues, they are hanging on our
every word ... and there is a difference in how the family will hear "You
should take OTC X" and "I recommend something like OTC X, if you know you
can take that."  The first sounds like an  order, the second a (ta da)
recommendation.

When in doubt, IBCLCs can fall back on my Tweet version of what will always
pass muster as legal and ethical care:  "Provide evidence-based information
and support so the parents can make an informed decision about their own
and their child's health care, after consultation with their primary HCP."

-- 
Liz Brooks, JD, IBCLC, FILCA
Wyndmoor, PA, USA
Director, Human Milk Banking Assn of North America (2015-19)
Adjunct Professor, Drexel Univ, Public Policy of Breastfeeding
"IBCLCs empower women and save babies' lives!"-Ursuline Singleton

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