What would I do in a situation like this, where the LC feels APNO would be helpful but the primary hcp says the mother must not use it? or mom is told she must not use a vaginal preparation while breastfeeding? Unfortunately since the prevailing mindset in recent history has been to wean for any and all pharmaceutical use, we will have to educate. Lucky we have the likes of Hale and Newman and others who provide wonderful resources for us. In the case presented, it sounds as if the mother was secure in using the vaginal preparation but was hesitant to use the apno. You could provide her the references, Newmans' articles online, or offer her other options (maybe she could use gentian violet?). I find mothers are hesitant to let the baby suckle where the cream was used. I might say that I know many doctors who prescribe it and do not advise wiping it off, but that she could gently rinse it if she preferred with warm water prior to feeding. If I felt it would get me somewhere with a particular doc and I had the time, I might call the doc, or fax over the ref to the doc as "FYI." She might also go to a dermatologist. Since this could be considered a prescribing situation, the LC, if not licensed to prescribe, is treading on thin ice legally, in my interpretation. Now, when the conflict is over something like normal physiologic jaundice in a well-feeding baby, which I encounter frequently, I am very confident telling the mother I strongly disagree with the advice of stopping breastfeeding, supplementing with formula, or topping off with water, for example. I then give my rationale etc. If you are knowledgeable, professional, and strictly state your position w/o slamming the other professional, you should be ok. P.S. If you ask the doc for refs he may very well be able to provide them as many of the drug literature will say don't use while bf. Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA _________________________________________________________________ MSN 8 helps eliminate e-mail viruses. Get 2 months FREE* http://join.msn.com/?page=features/virus *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] 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