Barbara said:
I've found that propaganda that brands
them as unequivicably evil can make it difficult for parents to trust the
LC
who occasionally recommends them, even if she has a reasonable clinical
rationale for doing so.  And I think that it also inhibits the discussion
on
how to use tools when there is such a risk of being criticized if you admit
to trying a new technique.

This same attitude is important to re-consider whenever we are discussing
another professional's choices of recommendations about a lot of things...

As we were not there during the visit, we don't know why the previous
professionals chose this course of action.  It is amazing how different a
mom/baby will behave from one day to another (in fact, from one hour to
another).  

I have been in to see moms in hospital, seen a few others, come back, and
found totally different behaviors in baby (no tongue thrusting to LOTS of
tongue thrusting, arching baby to relaxed baby, etc...) and mother.  

I have had Public Health Nurses call me from mom's home and describe one
thing - then we visit the next day and things are different.  I choose NOT
to BLAME the PHN, but to agree with her that things are different - and
that NOW we may want to try... thus and so...

Having been in a job where I saw moms other LCs had seen previously, we
agreed to follow whatever course the first LC chose UNLESS we saw it was
obviously not working - then we would NOT criticize the previous LC
(thereby making the mom feel she's stuck between two professionals who
can't make up their minds, so how can she know who is right), but to say:
well, why don't we try this now... it seems this other course has done as
much as it can, and now we need to try this step.  

I don't consider this being "untruthful" - we have no idea what the first
LC or professional saw.  We only can go forward from this place in time.  

Of course I am not speaking about hiding unethical or dangerous behavior. 
I am speaking about the multiple choices that different professionals may
choose, any of which may be appropriate based on his/her experience and
what they saw at the time...


Jeanette Panchula, BSW, LLLL, RN, IBCLC
Vacaville, CA

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