Free Breastfeeding Clinic in your area?

[Guest guest]

Hi all -

I have been reading the posts about how many mothers you all see per year, and

it got me thinking. I will be sitting boards in 2012, and since I am not an RN

and will be doing in-home PP only, I am wondering if I am going up against

something that will prevent Moms from seeking my help. Our local hospital has a

" Breastfeeding Clinic " that is staffed by RN IBCLCs only, and they are a walk-in

clinic (daytime hours, mostly during the week, but some appointments on

weekends) that ANYONE can go to at any time for breastfeeding help... FOR FREE.

And they even give you a free parking pass to boot . The other hospital in

town has a RN IBCLC who is also a nurse practitioner with whom Moms can make an

appointment and then usually just have to pay a co-pay for their insurance, if

they have insurance (also daytime hours, weekdays only). Am I going to have ANY

clients whatsoever with these types of services being offered? I know that as a

LLL Leader, I do a lot of home visits with Moms who haven't " gotten what they

needed " from the hospital based program, but obviously they aren't paying for

this service either. My friend, who is a popular doula in the area, polled 100

of her clients, asking if they would use this service and if so, how much they

would pay for in home consultation by an IBCLC. The results were good, with the

majority saying " ABSOLUTELY! " , but then they said " we'd pay $20-$30 for this

service " . Seriously??? I want to have the feeling that we are all in this

together, working for the greater good, but in the back of my mind I keep

thinking " what if I never have any calls??? " . Any advice, comments, etc. would

be wonderful!!! Thanks!

Jodi Fan, LLLL

Champaign-Urbana

[Guest guest]

I don't beleive that you have to be an RN to be a good IBCLC. I too am

a LLLL and have been for 7 years. I am not a nurse and have no

interest in being a nurse. My passion is helping breastfeeding moms

and babies. My business partner also became an IBCLC through a

non-medical route. I think that it is good for our profession to have

LC's from medical backgrounds and non-medical backgrounds. I think it

enables us to sometimes see things differently. In other words you can

be a fabulous LC with or without being an RN too.

Our private practice is in a major metropolitan area. We have lots of

hospitals around us and there are a lot of LC's and groups that are

hospital based. There are also several options for calling a private

practice consultant. That being said, we stay fairly busy. Not to toot

our horns, but we see a lot of moms that have already seen several

other people and we clean up messes quite frequently. We work really

hard to network in the local birth community and with pedi offices

that are breastfeeding friendly. We run a weekly support group that

also gets our name out there. It doesn't make us a penny (and in

reality might actually cost us constults), but it gets our information

out there. We also work very hard to educate ourselves and stay up on

current research. It didn't happen overnight by any means. My partner

worked for several years before she actually turned a profit, but they

say if you start a business to plan for 3-5 years before you should

see a profit. I had it a little better in that I joined her after our

group name was already somewhat known. Most of our business is

referral. I don't think when moms are looking for help that they are

looking only for an RN LC. They are looking for help anywhere they can

find it and the more moms you help the more your name gets out there

and the larger your practice will be.

It takes time and energy. You will never be rich being an LC, but if

it's what you love it is worth it. Don't give up just because you

aren't a nurse. You can still be a marvelous LC! Just my 2 cents.

Deirdre Cannon, IBCLC, LLLL

For Babies' Sake

www.forbabiessake.com

Find us on Facebook!

Quoting Jodi :

> Hi all -

>

> I have been reading the posts about how many mothers you all see per

> year, and it got me thinking. I will be sitting boards in 2012, and

> since I am not an RN and will be doing in-home PP only, I am

> wondering if I am going up against something that will prevent Moms

> from seeking my help. Our local hospital has a " Breastfeeding

> Clinic " that is staffed by RN IBCLCs only, and they are a walk-in

> clinic (daytime hours, mostly during the week, but some appointments

> on weekends) that ANYONE can go to at any time for breastfeeding

> help... FOR FREE. And they even give you a free parking pass to boot

> . The other hospital in town has a RN IBCLC who is also a nurse

> practitioner with whom Moms can make an appointment and then usually

> just have to pay a co-pay for their insurance, if they have

> insurance (also daytime hours, weekdays only). Am I going to have

> ANY clients whatsoever with these types of services being offered? I

> know that as a LLL Leader, I do a lot of home visits with Moms who

> haven't " gotten what they needed " from the hospital based program,

> but obviously they aren't paying for this service either. My friend,

> who is a popular doula in the area, polled 100 of her clients,

> asking if they would use this service and if so, how much they would

> pay for in home consultation by an IBCLC. The results were good,

> with the majority saying " ABSOLUTELY! " , but then they said " we'd pay

> $20-$30 for this service " . Seriously??? I want to have the feeling

> that we are all in this together, working for the greater good, but

> in the back of my mind I keep thinking " what if I never have any

> calls??? " . Any advice, comments, etc. would be wonderful!!! Thanks!

>

> Jodi Fan, LLLL

> Champaign-Urbana

>

>

[Guest guest]

I agree.  Hospital LC's offer services at a low cost, because they can.  I worked at a hospital in land and the lactation services were considered a " community service " and therefore didn't need to turn a profit.  We did a LOT of stuff for free and only charged a minimal fee for consults.

Since opening a private practice I've found that not every mother births in the hospital, nor would they use the hospital LC if they need help or have already seen the LC at the hospital and still need help.   The private practice LC provides a needed service in the community.  As Deirdre mentioned, it's important to make connections in the local birth community.  If the midwives, doulas and other birth professionals know you and trust in your skills, they will recommend you to their clients.  Almost 100% of my clients come as recommendations from the connections that I've made in the birth community.

One service that I really find to be very helpful in my area is that there are several pp LC's that offer free education to doula's and such in the area.  Ask to attend a local doula meeting, offer to give a short presentation on helping breastfeeding mothers and bring lots of business cards.  I really like feeling like we are a team working to help mothers have a great birth/postpartum experience.  If we can help train doula's and midwives, etc.. to both get moms off to a good start as well as recognize when an IBCLC should be consulted, every one wins.

Hope this helps,Jeannine s, B.A., IBCLCwww.capitalareabreastfeedingsupport.com

 

I don't beleive that you have to be an RN to be a good IBCLC. I too am

a LLLL and have been for 7 years. I am not a nurse and have no

interest in being a nurse. My passion is helping breastfeeding moms

and babies. My business partner also became an IBCLC through a

non-medical route. I think that it is good for our profession to have

LC's from medical backgrounds and non-medical backgrounds. I think it

enables us to sometimes see things differently. In other words you can

be a fabulous LC with or without being an RN too.

Our private practice is in a major metropolitan area. We have lots of

hospitals around us and there are a lot of LC's and groups that are

hospital based. There are also several options for calling a private

practice consultant. That being said, we stay fairly busy. Not to toot

our horns, but we see a lot of moms that have already seen several

other people and we clean up messes quite frequently. We work really

hard to network in the local birth community and with pedi offices

that are breastfeeding friendly. We run a weekly support group that

also gets our name out there. It doesn't make us a penny (and in

reality might actually cost us constults), but it gets our information

out there. We also work very hard to educate ourselves and stay up on

current research. It didn't happen overnight by any means. My partner

worked for several years before she actually turned a profit, but they

say if you start a business to plan for 3-5 years before you should

see a profit. I had it a little better in that I joined her after our

group name was already somewhat known. Most of our business is

referral. I don't think when moms are looking for help that they are

looking only for an RN LC. They are looking for help anywhere they can

find it and the more moms you help the more your name gets out there

and the larger your practice will be.

It takes time and energy. You will never be rich being an LC, but if

it's what you love it is worth it. Don't give up just because you

aren't a nurse. You can still be a marvelous LC! Just my 2 cents.

Deirdre Cannon, IBCLC, LLLL

For Babies' Sake

www.forbabiessake.com

Find us on Facebook!

Quoting Jodi :

> Hi all -

>

> I have been reading the posts about how many mothers you all see per

> year, and it got me thinking. I will be sitting boards in 2012, and

> since I am not an RN and will be doing in-home PP only, I am

> wondering if I am going up against something that will prevent Moms

> from seeking my help. Our local hospital has a " Breastfeeding

> Clinic " that is staffed by RN IBCLCs only, and they are a walk-in

> clinic (daytime hours, mostly during the week, but some appointments

> on weekends) that ANYONE can go to at any time for breastfeeding

> help... FOR FREE. And they even give you a free parking pass to boot

> . The other hospital in town has a RN IBCLC who is also a nurse

> practitioner with whom Moms can make an appointment and then usually

> just have to pay a co-pay for their insurance, if they have

> insurance (also daytime hours, weekdays only). Am I going to have

> ANY clients whatsoever with these types of services being offered? I

> know that as a LLL Leader, I do a lot of home visits with Moms who

> haven't " gotten what they needed " from the hospital based program,

> but obviously they aren't paying for this service either. My friend,

> who is a popular doula in the area, polled 100 of her clients,

> asking if they would use this service and if so, how much they would

> pay for in home consultation by an IBCLC. The results were good,

> with the majority saying " ABSOLUTELY! " , but then they said " we'd pay

> $20-$30 for this service " . Seriously??? I want to have the feeling

> that we are all in this together, working for the greater good, but

> in the back of my mind I keep thinking " what if I never have any

> calls??? " . Any advice, comments, etc. would be wonderful!!! Thanks!

>

> Jodi Fan, LLLL

> Champaign-Urbana

>

>

[Guest guest]

My opinion only.

This breastfeeding clinic that provides service "for free" to the client will only last as long as the hospital allows it. And as $$ become more scarce, this won't last long. I'm surprised it has lasted this long. The RN/IBCLCs that are running his clinic are being paid their usual hourly wage.

At this point, you can't compete unless you offer home visits. And your home visits need to compensate you for whatever it costs you to provide the service PLUS.....

Check into what it costs for a basic pediatrician visit -- no immunizations, nothing but a well-baby/child check up. Add at least 25% to that if you see moms and babies in your own office (they have to come to you), and add a minimum of 50% to that if you have to go to them (home visit). Explain that your visits are at least 1 to 1.5 hours, that you do an ac/pc weight and will develop a plan of care with the mother that takes into account her own personal situation.

Good luck!!

Jan

Hi all -I have been reading the posts about how many mothers you all see per year, and it got me thinking. I will be sitting boards in 2012, and since I am not an RN and will be doing in-home PP only, I am wondering if I am going up against something that will prevent Moms from seeking my help. Our local hospital has a "Breastfeeding Clinic" that is staffed by RN IBCLCs only, and they are a walk-in clinic (daytime hours, mostly during the week, but some appointments on weekends) that ANYONE can go to at any time for breastfeeding help... FOR FREE. And they even give you a free parking pass to boot . The other hospital in town has a RN IBCLC who is also a nurse practitioner with whom Moms can make an appointment and then usually just have to pay a co-pay for their insurance, if they have insurance (also daytime hours, weekdays only). Am I going to have ANY clients whatsoever with these types of services being offered? I know that as a LLL Leader, I do a lot of home visits with Moms who haven't "gotten what they needed" from the hospital based program, but obviously they aren't paying for this service either. My friend, who is a popular doula in the area, polled 100 of her clients, asking if they would use this service and if so, how much they would pay for in home consultation by an IBCLC. The results were good, with the majority saying "ABSOLUTELY!", but then they said "we'd pay $20-$30 for this service". Seriously??? I want to have the feeling that we are all in this together, working for the greater good, but in the back of my mind I keep thinking "what if I never have any calls???". Any advice, comments, etc. would be wonderful!!! Thanks!Jodi Fan, LLLLChampaign-Urbana

[Guest guest]

>Check into what it costs for a basic pediatrician visit -- no immunizations, nothing but a well-baby/child check up.  Add at least 25% to that if you see moms and babies in your own office (they have to come to you), and add a minimum of 50% to that if you have to go to them (home visit).  Explain that your visits are at least 1 to 1.5 hours, that you do an ac/pc weight and will develop a plan of care with the mother that takes into account her own personal situation.<Jan, the problem with that is that very VERY few mothers pay the true cost of those visits out of hand, because those that are not completely covered by some form of insurance usually have a low co-pay.

 Norma Ritter, IBCLC, RLCBreastfeeding Matters in the Capital Regionwww.NormaRitter.comJoin us on Facebook for the latest birthing and breastfeeding news and views:

http://tinyurl.com/BMCRonFB

[Guest guest]

Ah, Norma. That response netted me another handful of peanuts as I was attempting to formulate a response.

Sigh.

Peanuts gone. Didn't help.

You are right. But we still have to set our fees based on something. My personal opinion, FWIW, is that you set your fees -- mom pays or not. If she doesn't pay you as you require upfront....OK, let's say a mom calls you, you determine she needs a home/office visit. You say, "Initial visit is $125. That covers visit and follow up phone calls. Subsequent, followup visits are $90" Payment, check or cash, is expected at time of visit. I will give you a superbill for you to submit to your insurance company. I have no idea whether or not your company will reimburse your for all or part of your visit."

You give her a superbill based on lactation information, she can submit it or not. You get paid. If she gets paid -- that is between her and her insurance company.

As I said, my opinion only.

Jan

>Check into what it costs for a basic pediatrician visit -- no immunizations, nothing but a well-baby/child check up. Add at least 25% to that if you see moms and babies in your own office (they have to come to you), and add a minimum of 50% to that if you have to go to them (home visit). Explain that your visits are at least 1 to 1.5 hours, that you do an ac/pc weight and will develop a plan of care with the mother that takes into account her own personal situation.<Jan, the problem with that is that very VERY few mothers pay the true cost of those visits out of hand, because those that are not completely covered by some form of insurance usually have a low co-pay.

Norma Ritter, IBCLC, RLCBreastfeeding Matters in the Capital Regionwww.NormaRitter.comJoin us on Facebook for the latest birthing and breastfeeding news and views:http://tinyurl.com/BMCRonFB

[Guest guest]

Jan,I agree. Set the tone. When parents balk at my fees, which doesn't happen often - I live in NYC - I tell them in a non-confrontational way that formula costs about $2,500 for a year. I believe if we set fees that we can live with then we set the tone. This may sound silly but I am also a LLL Leader. Some moms want to pay for services. They don't respect free as much as what they pay for.Now, I am aware that there are many who cannot afford a private consultation - I do sliding scale and I also offer them to attend my support group which is $15. And, I send moms to LLL Meetings as well.We must value ourselves. Like one woman said a couple of days ago (I forgot who said it but I wholeheartedly agree!)- we must treat ourselves well - manicure, massage, whatever - we must also respect ourselves and our profession. Free clinic cannot compete with one-on-one in-home consultation.Leigh Anne in NYC

Ah, Norma. That response netted me another handful of peanuts as I was attempting to formulate a response.

Sigh.

Peanuts gone. Didn't help.

You are right. But we still have to set our fees based on something. My personal opinion, FWIW, is that you set your fees -- mom pays or not. If she doesn't pay you as you require upfront....OK, let's say a mom calls you, you determine she needs a home/office visit. You say, "Initial visit is $125. That covers visit and follow up phone calls. Subsequent, followup visits are $90" Payment, check or cash, is expected at time of visit. I will give you a superbill for you to submit to your insurance company. I have no idea whether or not your company will reimburse your for all or part of your visit."

You give her a superbill based on lactation information, she can submit it or not. You get paid. If she gets paid -- that is between her and her insurance company.

As I said, my opinion only.

Jan

>Check into what it costs for a basic pediatrician visit -- no immunizations, nothing but a well-baby/child check up. Add at least 25% to that if you see moms and babies in your own office (they have to come to you), and add a minimum of 50% to that if you have to go to them (home visit). Explain that your visits are at least 1 to 1.5 hours, that you do an ac/pc weight and will develop a plan of care with the mother that takes into account her own personal situation.<Jan, the problem with that is that very VERY few mothers pay the true cost of those visits out of hand, because those that are not completely covered by some form of insurance usually have a low co-pay.

Norma Ritter, IBCLC, RLCBreastfeeding Matters in the Capital Regionwww.NormaRitter.comJoin us on Facebook for the latest birthing and breastfeeding news and views:http://tinyurl.com/BMCRonFB

Leigh Anne O'Connor, IBCLCleighanne625@...www.leighanneoconnor.comwww.mamamilkandme.wordpress.com(917) 596-3646

[Guest guest]

Thank you all for your wonderful responses. I am learning so much from you all!!

Jodi Fan

[Guest guest]

Jodi,

If no one is doing in-home IBCLC consultations where you live, then moms really don't have any idea what a realistic price for such a consultation would be. Although some mothers will choose not to pay your fee, some will. And as mothers are helped by you, you will get the reputation that you know what you are doing and that it is worth it to pay your fee.

Sixteen years ago, no one hear had ever heard of a Lactation Consultant. No one even knew what the word "lactation" meant, hence my choice of the name Breastfeeding Support Services. I started out charging only $40 for a 2-hr consultation because I knew I had to prove what I could do and that paying for such a service was not an insane thing to do. I gradually increased the fee, year by year--holding for a couple years in a row sometimes when the economy wasn't good. I still get some people who catch their breath when I say my fee is $90 for a 2-3 hr consultation, but most don't balk now. You shouldn't have to start at $40!! Most mothers have now at least *heard* of Lactation Consultants, even if they don't know what one could do for them. Set a reasonable fee, perhaps not quite as high as you think it should be, to get mothers interested so you start to build a reputation. You can

always increase the fee the following year as mothers get the idea that you have more to offer than other breastfeeding services around you.

Dee Kassing

Subject: Free "Breastfeeding Clinic" in your area?To: Date: Tuesday, November 15, 2011, 2:04 PM

Hi all -I have been reading the posts about how many mothers you all see per year, and it got me thinking. I will be sitting boards in 2012, and since I am not an RN and will be doing in-home PP only, I am wondering if I am going up against something that will prevent Moms from seeking my help. Our local hospital has a "Breastfeeding Clinic" that is staffed by RN IBCLCs only, and they are a walk-in clinic (daytime hours, mostly during the week, but some appointments on weekends) that ANYONE can go to at any time for breastfeeding help... FOR FREE. And they even give you a free parking pass to boot . The other hospital in town has a RN IBCLC who is also a nurse practitioner with whom Moms can make an appointment and then usually just have to pay a co-pay for their insurance, if they have insurance (also daytime hours, weekdays only). Am I going to have ANY clients whatsoever with these types of services being offered? I know that as a LLL

Leader, I do a lot of home visits with Moms who haven't "gotten what they needed" from the hospital based program, but obviously they aren't paying for this service either. My friend, who is a popular doula in the area, polled 100 of her clients, asking if they would use this service and if so, how much they would pay for in home consultation by an IBCLC. The results were good, with the majority saying "ABSOLUTELY!", but then they said "we'd pay $20-$30 for this service". Seriously??? I want to have the feeling that we are all in this together, working for the greater good, but in the back of my mind I keep thinking "what if I never have any calls???". Any advice, comments, etc. would be wonderful!!! Thanks!Jodi Fan, LLLLChampaign-Urbana

[Guest guest]

I just have to say...i can't believe mothers get a consult with the great Dee Kassing for only $90!!!  They have no idea how lucky they are.

Dee, I know you are well aware of what the market is in your area...but I still think you are under-charging!!

Healy

in Seattle - where I can charge $185 without anyone raising an eyebrow...

 

Jodi,

    If no one is doing in-home IBCLC consultations where you live, then moms really don't have any idea what a realistic price for such a consultation would be.  Although some mothers will choose not to pay your fee, some will.  And as mothers are helped by you, you will get the reputation that you know what you are doing and that it is worth it to pay your fee.

    Sixteen years ago, no one hear had ever heard of a Lactation Consultant.  No one even knew what the word " lactation " meant, hence my choice of the name Breastfeeding Support Services.  I started out charging only $40 for a 2-hr consultation because I knew I had to prove what I could do and that paying for such a service was not an insane thing to do.  I gradually increased the fee, year by year--holding for a couple years in a row sometimes when the economy wasn't good.  I still get some people who catch their breath when I say my fee is $90 for a 2-3 hr consultation, but most don't balk now.  You shouldn't have to start at $40!!  Most mothers have now at least *heard* of Lactation Consultants, even if they don't know what one could do for them.  Set a reasonable fee, perhaps not quite as high as you think it should be, to get mothers interested so you start to build a reputation.  You can

always increase the fee the following year as mothers get the idea that you have more to offer than other breastfeeding services around you.

    Dee Kassing

Subject: Free " Breastfeeding Clinic " in your area?

To: Date: Tuesday, November 15, 2011, 2:04 PM

 

Hi all -I have been reading the posts about how many mothers you all see per year, and it got me thinking. I will be sitting boards in 2012, and since I am not an RN and will be doing in-home PP only, I am wondering if I am going up against something that will prevent Moms from seeking my help. Our local hospital has a " Breastfeeding Clinic " that is staffed by RN IBCLCs only, and they are a walk-in clinic (daytime hours, mostly during the week, but some appointments on weekends) that ANYONE can go to at any time for breastfeeding help... FOR FREE. And they even give you a free parking pass to boot . The other hospital in town has a RN IBCLC who is also a nurse practitioner with whom Moms can make an appointment and then usually just have to pay a co-pay for their insurance, if they have insurance (also daytime hours, weekdays only). Am I going to have ANY clients whatsoever with these types of services being offered? I know that as a LLL

Leader, I do a lot of home visits with Moms who haven't " gotten what they needed " from the hospital based program, but obviously they aren't paying for this service either. My friend, who is a popular doula in the area, polled 100 of her clients, asking if they would use this service and if so, how much they would pay for in home consultation by an IBCLC. The results were good, with the majority saying " ABSOLUTELY! " , but then they said " we'd pay $20-$30 for this service " . Seriously??? I want to have the feeling that we are all in this together, working for the greater good, but in the back of my mind I keep thinking " what if I never have any calls??? " . Any advice, comments, etc. would be wonderful!!! Thanks!

Jodi Fan, LLLLChampaign-Urbana

[Guest guest]

I've been struggling with what to charge (I'm still setting up everything).

There are two LC offices I know of in the area. One charges $150 for an initial

consult, the other charges about $60 (but that's only for one hour). Another PP

LC charges $175 for home visits. I was thinking of charging $130, but was told

I was worth more. I would be doing home visits as well and they typically last

2 hours plus travel time. I think I've may go ahead and charge $150. That

seems to be about the industry standard around here. My plan, though was to

offer unlimited phone support for the first year after that initial consult.

$75 for follow up home visits. I'm still working on it.

Beach Babies Lactation Support, LLC.

> >

> >

> >

> > Subject: Free " Breastfeeding Clinic " in your area?

> > To:

> > Date: Tuesday, November 15, 2011, 2:04 PM

> >

> >

> > Hi all -

> >

> > I have been reading the posts about how many mothers you all see per year,

> > and it got me thinking. I will be sitting boards in 2012, and since I am

> > not an RN and will be doing in-home PP only, I am wondering if I am going

> > up against something that will prevent Moms from seeking my help. Our local

> > hospital has a " Breastfeeding Clinic " that is staffed by RN IBCLCs only,

> > and they are a walk-in clinic (daytime hours, mostly during the week, but

> > some appointments on weekends) that ANYONE can go to at any time for

> > breastfeeding help... FOR FREE. And they even give you a free parking pass

> > to boot . The other hospital in town has a RN IBCLC who is also a nurse

> > practitioner with whom Moms can make an appointment and then usually just

> > have to pay a co-pay for their insurance, if they have insurance (also

> > daytime hours, weekdays only). Am I going to have ANY clients whatsoever

> > with these types of services being offered? I know that as a LLL Leader, I

> > do a lot of home visits with Moms who haven't " gotten what they needed "

> > from the hospital based program, but obviously they aren't paying for this

> > service either. My friend, who is a popular doula in the area, polled 100

> > of her clients, asking if they would use this service and if so, how much

> > they would pay for in home consultation by an IBCLC. The results were good,

> > with the majority saying " ABSOLUTELY! " , but then they said " we'd pay

> > $20-$30 for this service " . Seriously??? I want to have the feeling that we

> > are all in this together, working for the greater good, but in the back of

> > my mind I keep thinking " what if I never have any calls??? " . Any advice,

> > comments, etc. would be wonderful!!! Thanks!

> >

> > Jodi Fan, LLLL

> > Champaign-Urbana

> >

> >

> >

>

[Guest guest]

Ladies,

Sending the primary care physician or practitioner a report

is not a nice thing to do or a marketing opportunity. It is a requirement /

duty of our Professional Standards to report to the health care team.

The act of reporting does not put one “under”

the authority of the person who receives the report. An IBCLC is a separate member

of the health care team.

The RN license or any other health professional

license (i.e. physician, midwife, social worker, dietician, doula, etc….)

one holds has nothing to do with the provision of care and responsibilities of

the IBCLC to adhere to these standards. When functioning in private

practice, these is the only required standards that must be met.

If one is employed by another entity and their job

description requires the IBCLC AND another kind of license, then

they are bound by both the IBCLC Standards and the standards for the other

license or certification.

Additionally, there may be laws within a jurisdiction related

to certain types of health care professionals that dictate responsibilities

they have whether on or off the job, for example “good Samaritan”

laws can apply to certain license holders who assist someone in an emergency. Whether

there are such laws in a state that mandate a nurse always perform under

nursing guidelines even when working as a private practice IBCLC, I do not

know. I do not believe any legislation specifically names an IBCLC in any state

with regard to this, but there may be something general. It will be different

in each of the 50 states.

Below are examples from the various documents:

Scope of Practice

IBCLCs have the duty

to report truthfully and fully to the mother and/or infant’s primary

health care provider and to the health care system by:

• recording all relevant information concerning care

provided and, where appropriate, retaining records for the time specified by

the local jurisdiction

IBCLCs have the duty to

preserve client confidence by:

• respecting the privacy, dignity and confidentiality

of mothers and families

IBCLCs have the duty to

act with reasonable diligence by:

• assisting families with decisions regarding the

feeding of children by providing information that is evidence-based and free of

conflict of interest

• providing follow-up services as required

• making necessary referrals to other health care

providers and community support resources when necessary

• functioning and contributing as a member of the

health care team to deliver coordinated services to women and families

• working collaboratively and interdependently with

other members of the health care team

• reporting to IBLCE if they have been found guilty

of any offence under the criminal code of their country or jurisdiction in

which they work or is sanctioned by another profession

• reporting to IBLCE any other IBCLC who is

functioning outside this Scope of Practice

Clinical Competencies

DOCUMENTATION

AND COMMUNICATION SKILLS WITH HEALTH PROFESSIONALS

The student will:

• Communicate effectively with other members of

the health care team, using written documents appropriate to the

geopolitical region, facility and culture in which the student is being

trained, such as: consent forms, care plans, charting forms/clinical notes,

pathways/care maps, and feeding assessment forms

• Use appropriate resources for research to provide

information to the health care team on conditions, modalities, and medications

that affect breastfeeding and lactation

• Write referrals and follow-up documentation/

letters to referring and/or primary health care providers that illustrate the

student’s ability to identify:

• The mother’s concerns or problems, planned

interventions, evaluation of outcomes and follow-up

• Situations in which immediate verbal communication

with the health care provider is necessary, such as serious illness in the

infant, child, or mother

• Report instances of child abuse or neglect to

specific agencies as mandated or appropriate

Code of Professional Conduct

Code

of Professional Conduct Principles

4. Report accurately

and completely to other members of the healthcare team

Every IBCLC shall:

4.1 Receive a client’s consent, before initiating a

consultation, to share clinical information with other members of the

client’s healthcare team.

4.2 Inform an appropriate

person or authority if it appears that the health or safety of a client or a

colleague is at risk, consistent with Principle 3.

Standards of Practice

Standard2. Legal Considerations

The IBCLC is obligated to practice within the laws of the

geopolitical region and setting in which she/he works. The IBCLC must practice

with consideration for rights of privacy and with respect for matters of a

confidential nature.

2.1 Work within the policies and procedures

of the institution where employed, or if self-employed, have identifiable

policies and procedures to follow

2.2 Clearly state applicable fees prior to

providing care

2.3 Obtain informed consent from all clients

prior to:

• assessing or intervening

• reporting relevant information to other health care

professional(s)

• taking photographs for any purpose

• seeking publication of information associated with

the consultation

2.4 Protect client confidentiality at all

times

2.5 Maintain records according to legal and

ethical practices within the work setting

Standard3. Clinical Practice

The clinical practice of the IBCLC focuses on providing

clinical lactation care and management. This is best accomplished by promoting

optimal health, through collaboration and problem-solving with the client and

other members of the health care team. The

role of the IBCLC includes:

• assessment, planning, intervention, and evaluation

of care in a variety of situations

• anticipatory guidance and prevention of problems

• complete, accurate, and timely documentation of

care

• communication and collaboration

with other health care professionals

3.1 Assessment

3.1.1 Obtain and document an appropriate

history of the breastfeeding mother and child

3.1.2 Systematically collect objective and

subjective information

3.1.3 Discuss with the mother and document as

appropriate all assessment information

3.3 Implementation

3.3.5 Facilitate referral to other health care

professionals, community services and support groups as needed

3.3.7 Document and communicate to health care

providers as

appropriate:

• assessment information

• suggested interventions

• instructions provided

• evaluations of outcomes

• modifications of the plan of care

• follow-up strategies

3.4 Evaluation

4.5 Share current evidence-based information

and clinical skills in collaboration with other health care providers

Judy

Judith

L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell

Phone

Fax

[Guest guest]

Wow! $185! Mothers would choke and hang up on me! I have been considering raising my fee by $10 for the new year, though.

Dee

Subject: Free "Breastfeeding Clinic" in your area?To: Date: Tuesday, November 15, 2011, 2:04 PM

Hi all -I have been reading the posts about how many mothers you all see per year, and it got me thinking. I will be sitting boards in 2012, and since I am not an RN and will be doing in-home PP only, I am wondering if I am going up against something that will prevent Moms from seeking my help. Our local hospital has a "Breastfeeding Clinic" that is staffed by RN IBCLCs only, and they are a walk-in clinic (daytime hours, mostly during the week, but some appointments on weekends) that ANYONE can go to at any time for breastfeeding help... FOR FREE. And they even give you a free parking pass to boot . The other hospital in town has a RN IBCLC who is also a nurse practitioner with whom Moms can make an appointment and then usually just have to pay a co-pay for their insurance, if they have insurance (also daytime hours, weekdays only). Am I going to have ANY clients whatsoever with these types of services being offered? I know that as a LLL

Leader, I do a lot of home visits with Moms who haven't "gotten what they needed" from the hospital based program, but obviously they aren't paying for this service either. My friend, who is a popular doula in the area, polled 100 of her clients, asking if they would use this service and if so, how much they would pay for in home consultation by an IBCLC. The results were good, with the majority saying "ABSOLUTELY!", but then they said "we'd pay $20-$30 for this service". Seriously??? I want to have the feeling that we are all in this together, working for the greater good, but in the back of my mind I keep thinking "what if I never have any calls???". Any advice, comments, etc. would be wonderful!!! Thanks!Jodi Fan, LLLLChampaign-Urbana

[Guest guest]

Me too, Dee! But I think I read somewhere that the standard home visit in Manhattan is $245 or something like that, so it really depends on where you live.

Jan

Wow! $185! Mothers would choke and hang up on me! I have been considering raising my fee by $10 for the new year, though.

Dee

Subject: Free "Breastfeeding Clinic" in your area?To: Date: Tuesday, November 15, 2011, 2:04 PM

Hi all -I have been reading the posts about how many mothers you all see per year, and it got me thinking. I will be sitting boards in 2012, and since I am not an RN and will be doing in-home PP only, I am wondering if I am going up against something that will prevent Moms from seeking my help. Our local hospital has a "Breastfeeding Clinic" that is staffed by RN IBCLCs only, and they are a walk-in clinic (daytime hours, mostly during the week, but some appointments on weekends) that ANYONE can go to at any time for breastfeeding help... FOR FREE. And they even give you a free parking pass to boot . The other hospital in town has a RN IBCLC who is also a nurse practitioner with whom Moms can make an appointment and then usually just have to pay a co-pay for their insurance, if they have insurance (also daytime hours, weekdays only). Am I going to have ANY clients whatsoever with these types of services being offered? I know that as a LLL Leader, I do a lot of home visits with Moms who haven't "gotten what they needed" from the hospital based program, but obviously they aren't paying for this service either. My friend, who is a popular doula in the area, polled 100 of her clients, asking if they would use this service and if so, how much they would pay for in home consultation by an IBCLC. The results were good, with the majority saying "ABSOLUTELY!", but then they said "we'd pay $20-$30 for this service". Seriously??? I want to have the feeling that we are all in this together, working for the greater good, but in the back of my mind I keep thinking "what if I never have any calls???". Any advice, comments, etc. would be wonderful!!! Thanks!Jodi Fan, LLLLChampaign-Urbana

[Guest guest]

I work and live in Manhattan. The most common home visit fee is $250. That is what I charge.Dee, I think you need to make your prices higher.Leigh Anne O'Connor, IBCLCleighanne625@...www.leighanneoconnor.comwww.mamamilkandme.wordpress.com(917) 596-3646

Me too, Dee! But I think I read somewhere that the standard home visit in Manhattan is $245 or something like that, so it really depends on where you live.

Jan

Wow! $185! Mothers would choke and hang up on me! I have been considering raising my fee by $10 for the new year, though.

Dee

Subject: Free "Breastfeeding Clinic" in your area?To: Date: Tuesday, November 15, 2011, 2:04 PM

Hi all -I have been reading the posts about how many mothers you all see per year, and it got me thinking. I will be sitting boards in 2012, and since I am not an RN and will be doing in-home PP only, I am wondering if I am going up against something that will prevent Moms from seeking my help. Our local hospital has a "Breastfeeding Clinic" that is staffed by RN IBCLCs only, and they are a walk-in clinic (daytime hours, mostly during the week, but some appointments on weekends) that ANYONE can go to at any time for breastfeeding help... FOR FREE. And they even give you a free parking pass to boot . The other hospital in town has a RN IBCLC who is also a nurse practitioner with whom Moms can make an appointment and then usually just have to pay a co-pay for their insurance, if they have insurance (also daytime hours, weekdays only). Am I going to have ANY clients whatsoever with these types of services being offered? I know that as a LLL Leader, I do a lot of home visits with Moms who haven't "gotten what they needed" from the hospital based program, but obviously they aren't paying for this service either. My friend, who is a popular doula in the area, polled 100 of her clients, asking if they would use this service and if so, how much they would pay for in home consultation by an IBCLC. The results were good, with the majority saying "ABSOLUTELY!", but then they said "we'd pay $20-$30 for this service". Seriously??? I want to have the feeling that we are all in this together, working for the greater good, but in the back of my mind I keep thinking "what if I never have any calls???". Any advice, comments, etc. would be wonderful!!! Thanks!Jodi Fan, LLLLChampaign-Urbana

Leigh Anne O'Connor, IBCLCleighanne625@...www.leighanneoconnor.comwww.mamamilkandme.wordpress.com(917) 596-3646

[Guest guest]

Our home visit fee is $150, which is twice the rate of some in the community

(Nashville). We are a group of four IBCLCs and also have an office where visits

are $100 for first initial work up. We would love to raise our rates (these have

been raised within the last yer). But you do have to consider your population.

If the general cost of living us lower, then consult costs are lower. However,

it is important to charge a fee that you feel adequately compensates you for

your time and expertise. It is a double edged sword.

Kate Cropp WHNP. IBCLC

Sent from my iPod

[Guest guest]

To add to Leigh Anne's comments, there was one individual who is neither an

IBCLC, nor even completed her course as a CLC that posted her rate as $250 per

HOUR. There is one IBCLC who is notorious (we've all had to follow up after her

cases) who never attends any of our continuing ed events, hosts a " guest breast "

where parents have complained that they were ONLY given the option of being the

guest breast if they wanted a consult, never allows a mother to use a pump or

even formula even if the baby is six weeks old and at birth weight (I'm not

kidding -- I've followed up on several of these), and has even had mothers

continue to feed on nipples that are so bad that they've been infected for two

months (again no kidding -- skin literally eaten away from the infection and mom

not allowed to pump). The $250 is the medium price for a reasonable IBCLC in

Manhattan.

As for clinics -- I actually keep mine low even though I do help moms with tubes

on the breast, write notecards for each visit with tips for EVERY MOM who

attends, test-weigh each baby - always with an explanation of what it means, and

sometimes even plot growth charts. I do the release forms too. I charge $25

which is the medium price. Recently the pediatric group that is now telling

moms to start sleep training at six weeks is charging $35 and the IBCLCs were

told that they shouldn't test weigh, shouldn't mention tongue tie and shouldn't

tell mothers to pump.

Best regards,

E. Burger, MHS, PhD, IBCLC

[Guest guest]

Um...what is a guest breast?

Peds group charges $35 for what? A breastfeeding clinic?

Isn't there something that you can do about the notorious IBCLC? (Not too much you can do about the non-CLC person...sigh...).

Oh my.

Jan

To add to Leigh Anne's comments, there was one individual who is neither an IBCLC, nor even completed her course as a CLC that posted her rate as $250 per HOUR. There is one IBCLC who is notorious (we've all had to follow up after her cases) who never attends any of our continuing ed events, hosts a "guest breast" where parents have complained that they were ONLY given the option of being the guest breast if they wanted a consult, never allows a mother to use a pump or even formula even if the baby is six weeks old and at birth weight (I'm not kidding -- I've followed up on several of these), and has even had mothers continue to feed on nipples that are so bad that they've been infected for two months (again no kidding -- skin literally eaten away from the infection and mom not allowed to pump). The $250 is the medium price for a reasonable IBCLC in Manhattan.As for clinics -- I actually keep mine low even though I do help moms with tubes on the breast, write notecards for each visit with tips for EVERY MOM who attends, test-weigh each baby - always with an explanation of what it means, and sometimes even plot growth charts. I do the release forms too. I charge $25 which is the medium price. Recently the pediatric group that is now telling moms to start sleep training at six weeks is charging $35 and the IBCLCs were told that they shouldn't test weigh, shouldn't mention tongue tie and shouldn't tell mothers to pump. Best regards, E. Burger, MHS, PhD, IBCLC

[Guest guest]

>Recently the pediatric group that is now telling moms to start sleep training at six weeks is charging $35 and the IBCLCs were told that they

shouldn't test weigh, shouldn't mention tongue tie and shouldn't tell mothers to pump. <Setting aside the fee issue for now...This is not the first time I have heard about IBCLCs, most commonly those is hospital situations, not being allowed to talk about TT etc.Please help me understand how this is possible. How can it be anything BUT malpractice to deliberately withhold relevant information from clients?

normaNorma Ritter, IBCLC, RLCBreastfeeding Matters in the Capital Regionwww.NormaRitter.comJoin us on Facebook for the latest birthing and breastfeeding news and views:

http://tinyurl.com/BMCRonFB

[Guest guest]

there are several peds in my area who have told me it's not my job to indicate a tt. grrr. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re:

Free "Breastfeeding Clinic" in your area?To: Date: Wednesday, November 23, 2011, 6:34 AM

>Recently the pediatric group that is now telling moms to start sleep training at six weeks is charging $35 and the IBCLCs were told that they

shouldn't test weigh, shouldn't mention tongue tie and shouldn't tell mothers to pump. <Setting aside the fee issue for now...This is not the first time I have heard about IBCLCs, most commonly those is hospital situations, not being allowed to talk about TT etc.Please help me understand how this is possible. How can it be anything BUT malpractice to deliberately withhold relevant information from clients?

normaNorma Ritter, IBCLC, RLCBreastfeeding Matters in the Capital Regionwww.NormaRitter.comJoin us on Facebook for the latest birthing and breastfeeding news and views:

http://tinyurl.com/BMCRonFB

[Guest guest]

But it is. We are there to help the breastfeeding relationship and if we see something that might be an indicator of low intake or sore nipples then it is our well within our job description to let moms know this. Reminds me of the nurses at our hospital getting in big trouble because some of them began to let mothers know the risks of getting depo-provera after birth, before leaving the hospital. Didn't matter that it was after 48 hours the risk of losing the milk was still there. They won their case because as an R.N. they are to educate the mothers about any risks to any medication or procedure. Cheryl n, IBCLC To: Sent: Wednesday, November 23, 2011 11:14 AM Subject: Re: Re: Free "Breastfeeding Clinic" in your area?

there are several peds in my area who have told me it's not my job to indicate a tt. grrr. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re:

Free "Breastfeeding Clinic" in your area?To: Date: Wednesday, November 23, 2011, 6:34 AM

>Recently the pediatric group that is now telling moms to start sleep training at six weeks is charging $35 and the IBCLCs were told that they

shouldn't test weigh, shouldn't mention tongue tie and shouldn't tell mothers to pump. <Setting aside the fee issue for now...This is not the first time I have heard about IBCLCs, most commonly those is hospital situations, not being allowed to talk about TT etc.Please help me understand how this is possible. How can it be anything BUT malpractice to deliberately withhold relevant information from clients?

normaNorma Ritter, IBCLC, RLCBreastfeeding Matters in the Capital Regionwww.NormaRitter.comJoin us on Facebook for the latest birthing and breastfeeding news and views:

http://tinyurl.com/BMCRonFB

[Guest guest]

$250. That is an amazing amount of money for one consultation. No one here would ever pay that kind of money, though it's interesting to think about making that kind of money. Wow!

Dee

Subject: Free "Breastfeeding Clinic" in your area?To: Date: Tuesday, November 15, 2011, 2:04 PM

Hi all -I have been reading the posts about how many mothers you all see per year, and it got me thinking. I will be sitting boards in 2012, and since I am not an RN and will be doing in-home PP only, I am wondering if I am going up against something that will prevent Moms from seeking my help. Our local hospital has a "Breastfeeding Clinic" that is staffed by RN IBCLCs only, and they are a walk-in clinic (daytime hours, mostly during the week, but some appointments on weekends) that ANYONE can go to at any time for breastfeeding help... FOR FREE. And they even give you a free parking pass to boot . The other hospital in town has a RN IBCLC who is also a nurse practitioner with whom Moms can make an appointment and then usually just have to pay a co-pay for their insurance, if they have insurance (also daytime hours, weekdays only). Am I going to have ANY clients whatsoever with these types of services being offered? I know that as a LLL

Leader, I do a lot of home visits with Moms who haven't "gotten what they needed" from the hospital based program, but obviously they aren't paying for this service either. My friend, who is a popular doula in the area, polled 100 of her clients, asking if they would use this service and if so, how much they would pay for in home consultation by an IBCLC. The results were good, with the majority saying "ABSOLUTELY!", but then they said "we'd pay $20-$30 for this service". Seriously??? I want to have the feeling that we are all in this together, working for the greater good, but in the back of my mind I keep thinking "what if I never have any calls???". Any advice, comments, etc. would be wonderful!!! Thanks!Jodi Fan, LLLLChampaign-Urbana

Leigh Anne O'Connor, IBCLC

leighanne625@...

www.leighanneoconnor.com

www.mamamilkandme.wordpress.com

[Guest guest]

My fee is 165 per consult. it's been that rate for many years now. No one thinks it's high..but that doesn't mean I'm making tons of money! we all know what goes into having a private practice! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Free "Breastfeeding Clinic" in your area?To: Date: Wednesday, November 23, 2011, 7:56 PM

$250. That is an amazing amount of money for one consultation. No one here would ever pay that kind of money, though it's interesting to think about making that kind of money. Wow!

Dee

Subject: Free "Breastfeeding Clinic" in your area?To: Date: Tuesday, November 15, 2011, 2:04 PM

Hi all -I have been reading the posts about how many mothers you all see per year, and it got me thinking. I will be sitting boards in 2012, and since I am not an RN and will be doing in-home PP only, I am wondering if I am going up against something that will prevent Moms from seeking my help. Our local hospital has a "Breastfeeding Clinic" that is staffed by RN IBCLCs only, and they are a walk-in clinic (daytime hours, mostly during the week, but some appointments on weekends) that ANYONE can go to at any time for breastfeeding help... FOR FREE. And they even give you a free parking pass to boot . The other hospital in town has a RN IBCLC who is also a nurse practitioner with whom Moms can make an appointment and then usually just have to pay a co-pay for their insurance, if they have insurance (also daytime hours, weekdays only). Am I going to have ANY clients whatsoever with these types of services being offered? I know that as a LLL

Leader, I do a lot of home visits with Moms who haven't "gotten what they needed" from the hospital based program, but obviously they aren't paying for this service either. My friend, who is a popular doula in the area, polled 100 of her clients, asking if they would use this service and if so, how much they would pay for in home consultation by an IBCLC. The results were good, with the majority saying "ABSOLUTELY!", but then they said "we'd pay $20-$30 for this service". Seriously??? I want to have the feeling that we are all in this together, working for the greater good, but in the back of my mind I keep thinking "what if I never have any calls???". Any advice, comments, etc. would be wonderful!!! Thanks!Jodi Fan, LLLLChampaign-Urbana

Leigh Anne O'Connor, IBCLC

leighanne625@...

www.leighanneoconnor.com

www.mamamilkandme.wordpress.com

[Guest guest]

writes,”To add to Leigh Anne's comments, there

was one individual who is neither an IBCLC, nor even completed her course as a

CLC that posted her rate as $250 per HOUR. There is one IBCLC who is notorious

(we've all had to follow up after her cases) who never attends any of our

continuing ed events, hosts a " guest breast " where parents have

complained that they were ONLY given the option of being the guest breast if

they wanted a consult, never allows a mother to use a pump or even formula even

if the baby is six weeks old and at birth weight (I'm not kidding -- I've

followed up on several of these), and has even had mothers continue to feed on

nipples that are so bad that they've been infected for two months (again no

kidding -- skin literally eaten away from the infection and mom not allowed to

pump). The $250 is the medium price for a reasonable IBCLC in Manhattan.”

This is why we need licensure with the qualification that

one is an IBCLC to be licensed. This would mean that licensed individuals would

be readily recognizable to the public and would be subject to disciplinary

procedures as written into the legislation and for the IBLCE. This person could

be reported to appropriate authorities. It is for the consumer protection!

Judy

Judith

L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell

Phone

Fax

[Guest guest]

It is

entirely possible to assess tongue function objectively using the Hazelbaker Assessment Tool for

Lingual Frenulum Function (ATLFF). This tool, and your assessment scores can be discussed

and shared with the mother and provided to the PCP without diagnosing a tongue tie. In this way, one gives the

parents correct, evidence based information and still not “diagnose”

tongue-tie. You can describe the tight frenulum and limited movement and

discuss how these are sometimes treated and refer the mother to medical

professionals who can evaluate and diagnose.

Judy

Judith

L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell

Phone

Fax