Jaye, I agree that this situation calls for some form of action. You have heard the mother's story and seen her breasts. You know the other practitioners involved. Do you have reason to think they would not welcome a letter from you? If the tables were turned and they were seeing a woman you had been helping, and felt you had missed some major point in the big picture, wouldn't you appreciate having them let you know? What made the mother contact you? Is there a chance the midwives mentioned it might be a good idea, or does she know of you by some other connection? I'm searching for something that might allow you to cut the midwives just a millimeter or two of slack. Of course you will have to get the mother's approval to contact them, after explaining to her what the purpose is (an attempt to prevent the same thing happening to someone else). Then you could send them something along the lines of this, which gets the point across but gives them some face-saving options for getting in touch, as well as accounts for the fact that you have not heard their side of it yet: Dear XX, I was contacted by NN, your midwifery client. I am writing this after conferring with her, and with her blessings. She seems to have understood that you advised her to continue simply breastfeeding her baby despite increasing pain and visible nipple trauma, which by the time I saw her had developed into potentially life-threatening mastitis. Further, she gathered that you felt she should not contact her doctor. Her milk production on the affected side is very low at present; we hope that with appropriate treatment we can recover it. I am concerned that her understanding of your advice seems to have led to a delay in seeking effective care for this serious condition. Perhaps we could work together to prepare some written materials for your clients on what to expect in the early days, and what things should lead to prompt attention by a doctor to avoid serious complications that could at worst lead to premature weaning. That way you could avoid problems arising from an overwhelmed mother having to remember a lot of details too. If she or I has misunderstood your advice, then perhaps we could simply review how it was presented, to try to find a way to do so more clearly and effectively in future. I'd hate to see any other mothers suffer the way NN has. It really isn't necessary; the help is there, but mothers - and other health practitioners - need to know when to access it. Sincerely, Bla Blahdeblah, IBCLC Of course, I know what I would do in a case like this - probably call the person at 2 am, after concealing my phone number, and whisper expletives at them about how they shouldn't show themselves in polite society if they are that ignorant and they should be run out of town on a rail after being tarred and feathered, at the very least. But afterwards I would wish I had taken some deep breaths and then tried an adult approach like this. And I know for sure I would want anyone having doubts about my skills after having inherited one of my fiascos, to contact me and give me a chance to learn something from it. Rachel Myr Kristiansand, Norway *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]