Nancy Wight makes the point that it is dangerous to be getting care from different people possibly in different places who aren't communicating with each other, which is an argument for sharing information and (possibly, though I am not convinced) an argument for designating one profession as having authority to coordinate the teamwork of all the others. I wonder how one decides which physician gets the last word about children who are cared for by members of multiple specialties? I'm not trying to be snotty here, really - I am curious. But mostly I'm guessing that Nancy's view is colored by her work setting, with vulnerable babies, often in hospital, whose nutrition (and general health) may be precarious and certainly not something they can be assumed to fixing on their own. In such cases, where there are concurrent medical problems impacting on, and being impacted on by, the feeding, it is only natural that all parties involved behave like a team. Where I live, the de facto coordinator of such teams is the mother, because nobody else talks to everyone on the team, they don't usually have meetings with every discipline present. Not saying this is desirable, and in fact many parents complain at the lack of a coordinator in the herd of clinicians they have to be in touch with regularly. But it's the way it is. (Also, the only children here who are regularly seen by pediatricians are the chronically ill children and I don't mean the ones with frequent stuffy noses. Normal children in need of care for a single episode of non-serious illness would be seen by their family GP.) For many breastfeeding problems there is no earthly reason to involve any health care providers, except the IBCLC (assuming we consider ourselves health care providers, and not 'normal life advisors' or 'infant cuisine experts' or whatever). If the child is well but the mother is very sore, or struggling to establish supply, or maintain it after going out to work, or just trying to find her way with breastfeeding as her healthy child matures and changes, she needs contact with someone who understands breastfeeding. Period. If in the course of working out her problem the IBCLC uncovers medical factors of significance, it would be natural to refer the woman to whomever she normally gets care for those kinds of things - and I would make sure she had something in writing from me to share with that practitioner so they know why I have advised her to seek their care. Seems to me IBLCE could benefit from a field trip into the world where we practice, to see the diversity in the way health services and whole societies are organized. Rachel Myr Kristiansand, Norway *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome