Chris mused, << Does anyone have a gentle way that I might present this to the IBCLC who made the recommendation or should I just ignore it and let it go? >> OK, I'm no LC. But specializing as I do in persuasive presentations, I'd start by agreeing with her. Basically you do AGREE about what is wrong with this dyad -- that their bf is being messed up, probably temporarily, by his teething troubles. And both of you had "fixes" that addressed the temporary nature of the problem. So that's a lot of agreement -- most, actually. The only thing you disagree about is what is the best, least intrusive, fix, the least likely to cause other problems in the meantime. So don't get to the disagreement yet -- just agree for a minute, first. This also tells her that you are respectful of her, that you treated this "2nd opinion" request not so differently from a referral -- you are checking back about "her" patient. This may make it easier for her to hear what you are going to tell her when the other shoe drops, in five minutes. Then, if you are comfortable with it, you might even ask her about her shield recommendation here. Has she had good luck getting onto (and safely back off of!) shield in this kind of situation? or did she feel that mom was begging for some kind of fix-it and this was all she could come up with but was ambivalent herself? Or what? Now, having had this hopefully-OK conversation so far, you can say that "the mother seemed concerned about the shield, and in fact you, too, have seen dyads with shield-caused trouble, and so you were glad to have this other solution that you could recommend. Has she tried working with these tinctures? It worked great for this baby, in general you've had great results with it, you'd be happy to fax over the label, etc." NB -- sending this in writing is a good follow up and lets her look at it later, when her possible defensiveness has worn off. "And the nice thing is that for those babies -- even if they are a minority -- for whom getting back off the shield can be a problem (or supply, or whatever you don't like about shields), they don't present that kind of trouble. etc. You just stop giving the drops, and the drops themselves are totally safe, etc etc." "And anyway, thanks, good to talk to you, always important to share resources with colleagues, blah blah." Naturally no anti-defensiveness measure works perfectly, and and nobody loves being criticized; and if she is at all smart, and you are still annoyed when you are speaking, she'll know it from listening to you. But organizing the conversation this way can sometimes lessen that effect, anyway. Good luck -- Elisheva Urbas *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html