Re: Consents for Breastfeeding Support Group?

November 18, 2011

my gosh i hope not! but i tell moms in my group that can't make a diagnosis unless I see them for a real consult. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Consents for

Breastfeeding Support Group?To: Date: Thursday, November 17, 2011, 6:22 PM

So I have a tricky situation. I had a mom call me for breastfeeding advice but couldn't pay. I told her to come to my new mom's group. It turns out the baby had a PTT and I referred her for a release which she did. Now the baby seems to have more issues. Although I sent her on to a doctor, do I have to have a release if she was just a drop in a group and made the appointment herself? Do I have to have every member of the group sign consents for treatment as if I were doing a private consultation?

November 18, 2011

so what would you do if you saw every symptom of PTT but the mother could not pay for a consult? See that's what's so frustrating about this job (even though I truly love it with all my heart), I have every liability as a RN-IBCLC but yet I can't get paid to risk that liability. What do I do when I love this so much and empathize with these mothers? Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Thursday, November 17, 2011 9:27 PM Subject: Re: Consents for Breastfeeding Support Group?

my gosh i hope not! but i tell moms in my group that can't make a diagnosis unless I see them for a real consult. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Consents for

Breastfeeding Support Group?To: Date: Thursday, November 17, 2011, 6:22 PM

So I have a tricky situation. I had a mom call me for breastfeeding advice but couldn't pay. I told her to come to my new mom's group. It turns out the baby had a PTT and I referred her for a release which she did. Now the baby seems to have more issues. Although I sent her on to a doctor, do I have to have a release if she was just a drop in a group and made the appointment herself? Do I have to have every member of the group sign consents for treatment as if I were doing a private consultation?

November 18, 2011

I usually word things differently at the support group. I don't do any invasive looking around or even the hazelbacker tool. I just say, that looks like it may be a tongue tie. Here's a dr. that can help evaluate it more thoroughly and clip if necessary. I NEVER diagnose. Actually I pretty much don't diagnose in a consultation either. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- On Thu, 11/17/11,

Dana Schmidt wrote:Subject: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Thursday, November 17, 2011, 6:32 PM

so what would you do if you saw every symptom of PTT but the mother could not pay for a consult? See that's what's so frustrating about this job (even though I truly love it with all my heart), I have every liability as a RN-IBCLC but yet I can't get paid to risk that liability. What do I do when I love this so much and empathize with these mothers? Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Thursday, November 17, 2011 9:27 PM Subject: Re: Consents for Breastfeeding Support

Group?

my gosh i hope not! but i tell moms in my group that can't make a diagnosis unless I see them for a real consult. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Consents for

Breastfeeding Support Group?To: Date: Thursday, November 17, 2011, 6:22 PM

So I have a tricky situation. I had a mom call me for breastfeeding advice but couldn't pay. I told her to come to my new mom's group. It turns out the baby had a PTT and I referred her for a release which she did. Now the baby seems to have more issues. Although I sent her on to a doctor, do I have to have a release if she was just a drop in a group and made the appointment herself? Do I have to have every member of the group sign consents for treatment as if I were doing a private consultation?

November 18, 2011

Diagnose was the wrong word. I did not do a Hazelbaker. I did a brief assessment and gave the card to the correct doctor for a revision to let him to a more thorough exam. Arg, I have a pit in my stomach. Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the

minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Thursday, November 17, 2011 9:48 PM Subject: Re: Consents for Breastfeeding Support Group?

I usually word things differently at the support group. I don't do any invasive looking around or even the hazelbacker tool. I just say, that looks like it may be a tongue tie. Here's a dr. that can help evaluate it more thoroughly and clip if necessary. I NEVER diagnose. Actually I pretty much don't diagnose in a consultation either. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- On Thu, 11/17/11,

Dana Schmidt wrote:Subject: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Thursday, November 17, 2011, 6:32 PM

so what would you do if you saw every symptom of PTT but the mother could not pay for a consult? See that's what's so frustrating about this job (even though I truly love it with all my heart), I have every liability as a RN-IBCLC but yet I can't get paid to risk that liability. What do I do when I love this so much and empathize with these mothers? Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Thursday, November 17, 2011 9:27 PM Subject: Re:

Consents for Breastfeeding Support

Group?

my gosh i hope not! but i tell moms in my group that can't make a diagnosis unless I see them for a real consult. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Consents for

Breastfeeding Support Group?To: Date: Thursday, November 17, 2011, 6:22 PM

So I have a tricky situation. I had a mom call me for breastfeeding advice but couldn't pay. I told her to come to my new mom's group. It turns out the baby had a PTT and I referred her for a release which she did. Now the baby seems to have more issues. Although I sent her on to a doctor, do I have to have a release if she was just a drop in a group and made the appointment herself? Do I have to have every member of the group sign consents for treatment as if I were doing a private consultation?

November 18, 2011

, I understand what you’re saying, but how do you handle situations in a consultation where you know the pediatrician, and know he/she will not identify the tongue tie, as I’ve seen happen with posterior tongue ties? From: [mailto: ] On Behalf Of BeebeSent: Thursday, November 17, 2011 9:49 PMTo: Subject: Re: Consents for Breastfeeding Support Group? I usually word things differently at the support group. I don't do any invasive looking around or even the hazelbacker tool. I just say, that looks like it may be a tongue tie. Here's a dr. that can help evaluate it more thoroughly and clip if necessary. I NEVER diagnose. Actually I pretty much don't diagnose in a consultation either. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months. --- Subject: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Thursday, November 17, 2011, 6:32 PM so what would you do if you saw every symptom of PTT but the mother could not pay for a consult? See that's what's so frustrating about this job (even though I truly love it with all my heart), I have every liability as a RN-IBCLC but yet I can't get paid to risk that liability. What do I do when I love this so much and empathize with these mothers? Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Thursday, November 17, 2011 9:27 PMSubject: Re: Consents for Breastfeeding Support Group? my gosh i hope not! but i tell moms in my group that can't make a diagnosis unless I see them for a real consult. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months. --- Subject: Consents for Breastfeeding Support Group?To: Date: Thursday, November 17, 2011, 6:22 PM So I have a tricky situation. I had a mom call me for breastfeeding advice but couldn't pay. I told her to come to my new mom's group. It turns out the baby had a PTT and I referred her for a release which she did. Now the baby seems to have more issues. Although I sent her on to a doctor, do I have to have a release if she was just a drop in a group and made the appointment herself? Do I have to have every member of the group sign consents for treatment as if I were doing a private consultation?

November 18, 2011

Why? You didn't do anything wrong. You referred her to someone to give a more thorough assessment. exactly the right thing IMO. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- From: Dana Schmidt

Subject: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Thursday, November 17, 2011, 6:51 PM

Diagnose was the wrong word. I did not do a Hazelbaker. I did a brief assessment and gave the card to the correct doctor for a revision to let him to a more thorough exam. Arg, I have a pit in my stomach. Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the

minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Thursday, November 17, 2011 9:48 PM Subject: Re: Consents for Breastfeeding Support Group?

I usually word things differently at the support group. I don't do any invasive looking around or even the hazelbacker tool. I just say, that looks like it may be a tongue tie. Here's a dr. that can help evaluate it more thoroughly and clip if necessary. I NEVER diagnose. Actually I pretty much don't diagnose in a consultation either. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- On Thu, 11/17/11,

Dana Schmidt wrote:Subject: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Thursday, November 17, 2011, 6:32 PM

so what would you do if you saw every symptom of PTT but the mother could not pay for a consult? See that's what's so frustrating about this job (even though I truly love it with all my heart), I have every liability as a RN-IBCLC but yet I can't get paid to risk that liability. What do I do when I love this so much and empathize with these mothers? Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Thursday, November 17, 2011 9:27 PM Subject: Re:

Consents for Breastfeeding Support

Group?

my gosh i hope not! but i tell moms in my group that can't make a diagnosis unless I see them for a real consult. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Consents for

Breastfeeding Support Group?To: Date: Thursday, November 17, 2011, 6:22 PM

So I have a tricky situation. I had a mom call me for breastfeeding advice but couldn't pay. I told her to come to my new mom's group. It turns out the baby had a PTT and I referred her for a release which she did. Now the baby seems to have more issues. Although I sent her on to a doctor, do I have to have a release if she was just a drop in a group and made the appointment herself? Do I have to have every member of the group sign consents for treatment as if I were doing a private consultation?

November 18, 2011

I don't refer to the ped. I refer to the resident expert on tongue ties here. and I often call the ped... but not if it's a group situation. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- From: Rosen

Subject: RE: Consents for Breastfeeding Support Group?To: Date: Thursday, November 17, 2011, 6:55 PM

, I understand what youâ€™re saying, but how do you handle situations in a consultation where you know the pediatrician, and know he/she will not identify the tongue tie, as Iâ€™ve seen happen with posterior tongue ties? From: [mailto: ] On Behalf Of BeebeSent: Thursday, November 17, 2011 9:49

PMTo: Subject: Re: Consents for Breastfeeding Support Group? I usually word things differently at the support group. I don't do any invasive looking around or even the hazelbacker tool. I just say, that looks like it may be a tongue tie. Here's a dr. that can help evaluate it more thoroughly and clip if necessary. I NEVER diagnose. Actually I pretty much don't diagnose in a consultation either. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula (206)

356-7252 www.second9months.comwww.facebook.com/thesecond9months. Subject: Consents for Breastfeeding Support Group?To: Date: Thursday, November 17, 2011, 6:22 PM So I have a tricky situation. I had a mom call me for breastfeeding advice but couldn't pay. I told her to come to my new mom's group. It turns out the baby had a PTT and I referred her for a release which she did. Now the baby seems to have more issues. Although I sent her on to a doctor, do I have to have a release if she was just a drop in a group and made the appointment herself? Do I have to have every member of the group sign consents for treatment as if I were doing a private

consultation?

November 18, 2011

Ladies,

Some food for thought….

If a mother cannot afford a necessary consult and she comes

to your support group where you end up providing an individual assessment of

the problem for her, such as evaluating the oral anatomy of the infant or providing

any other “individual” advice, are you in compliance with the “duties”

in the following items of the IBCLC Scope of Practice?

Is this really helpful to the mother?

IBCLCs have the duty to provide competent services for

mothers and

families by:

• performing

comprehensive maternal, child and feeding assessments

• developing

and implementing an individualized feeding plan in

consultation

with the mother

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

Judy

Judith

L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell

Phone

Fax

November 18, 2011

>

> So I have a tricky situation. I had a mom call me for breastfeeding advice

but couldn't pay. I told her to come to my new mom's group. It turns out the

baby had a PTT and I referred her for a release which she did. Now the baby

seems to have more issues. Although I sent her on to a doctor, do I have to

have a release if she was just a drop in a group and made the appointment

herself? Do I have to have every member of the group sign consents for

treatment as if I were doing a private consultation?

>

When I have a mom come to group for help I don't bother with a consent form. I

tell them what I am going to do, there are lots of people there to see what I am

doing. The moms don't care - they just want help. Nor do I get dr info and

send anything to them.

However, if a mom comes to group and baby has ongoing issues I do what I can to

do a full on consult. If that means she comes to me and I see her for free so

be it. But, then I do the consent form and all the normal stuff I would do

for a consult.

Warmly,

Jaye

November 18, 2011

This discussion is very interesting. Those of you who do support groups, do you run them like an LLL meeting; you are facilitating a discussion between the moms, and if someone needs hands on help, you refer them for a consult (in this case, to yourself?) Or do you let the moms discuss amongst themselves and give some hands on help to who needs it? I've had a lot of trouble imagining how a support group would work for us because of these questions- and because I lead an LLL meeting in my service area (where moms get great peer support, but I don't run it as a referral source, obviously). Running our own would get us more referrals, of course.

>

> So I have a tricky situation. I had a mom call me for breastfeeding advice but couldn't pay. I told her to come to my new mom's group. It turns out the baby had a PTT and I referred her for a release which she did. Now the baby seems to have more issues. Although I sent her on to a doctor, do I have to have a release if she was just a drop in a group and made the appointment herself? Do I have to have every member of the group sign consents for treatment as if I were doing a private consultation?

>

When I have a mom come to group for help I don't bother with a consent form. I tell them what I am going to do, there are lots of people there to see what I am doing. The moms don't care - they just want help. Nor do I get dr info and send anything to them.

However, if a mom comes to group and baby has ongoing issues I do what I can to do a full on consult. If that means she comes to me and I see her for free so be it. But, then I do the consent form and all the normal stuff I would do for a consult.

Warmly,

Jaye

-- Eden, BA, IBCLC, RLCLactation ConsultantAtlanta Breastfeeding Consultants, LLCwww.AtlantaBreastfeedingConsultants.com

(404)-590-MILK (6455)

November 18, 2011

Is it helpful to the mother?? Absolutely! In my experience I am often the

first LC mom has seen who actually gave her answers to her questions that made

sense. Often times I am the LC who cleans up train wrecks because other less

experienced LC's have no clue what they are looking at - especially with tongue

ties and muscular issues. I sure as hell wish they'd come and ask me for some

one on one teaching! They'd miss far fewer babies this way and far more babies

would get the help they need.

For example, a newer LC come into the middle of a case I was working on (I was

sick and mom just wanted positioning help so called a newer LC) and even though

mom told the LC I said the baby had a PTT (hard core Type 3 - nearly Type 4) and

structural issues (due to birth trauma) and she needed to work within babies

comfort levels, the LC said I was wrong! " Jaye is wrong - this baby is fine! "

Were her exact words to mom. Blew me away. This person is newer and does NOT

have my background. I have been in the field for 17yrs and specialize in

tongue-ties and structural issues. SHE KNOWS THIS! And yet...as a result of

her carelessness, Mom then started questioning herself, and had to have not only

me, but another LC I trust, as well as my Bowen Practitioner (who she was seeing

because baby was a mess from traumatic birth) AND the Dr (dentist) I sent her to

for evaluation tell her that YES baby DOES have a PTT and muscular issues and

the other one was WRONG! It delayed all treatment of this child for nearly 2

weeks as a result - and has led to more problems and a bigger mess to clean up -

much of it moms emotional security.

Another mom was told by 3 hosp LC's/nurses that her baby did not have a tongue

tie, but how odd that tongue isn't moving quite right...hmmm... I told the

parents flat out: Those who told them no TT were wrong, most likely due to

inexperience. Baby had a Type 2 TT and needed clipping. Showed them, had them

feel, gave them info - they got baby clipped yesterday. They weren't stupid -

they could see and feel the problem! But the lack of education and experience

can be appalling and can leave those of us with more experience and education

specializing in Train-Wreck clean-up more often than we like.

And lastly, another mom showed up in group several weeks ago, working with a

very nice LC I know but who does not yet have the experience to recognize subtle

structural issues. They'd been seen 3 times - with no improvement. I spotted

it right away because that is my specialty. Mom wants to know why the other one

doesn't know this stuff...I don't know. Why doesn't she? It's not like I

haven't offered my services to teach, for free, every LC who wants to know how

to evaluate a baby for structural issues and sneaky tongue ties. It's not like

they don't see it talked about on LN and how important it is to know how to

evaluate...and it's not like they don't have someone sitting in their own

backyard saying, " I'm here!! I can help you!! " Gotta wonder why they don't

take up the offer, you know? Hell I have LC's from around the country call me

and ask for assistance - I have done SKYPE consults now with other LC's to teach

them how to evaluate a baby...but the ones in my backyard?? Nothing. Whatever.

Now - back to the question of Scope of Practice. Here is my take and take it

for what you will. When moms get crappy ass service, no service or simply

uneducated/inexperienced service from others in our field, (NOT judging or

trying to sound like a bitch here - we all know it happens and we have all been

new and inexperienced and needed education) and they show up at MY group and

need help - I feel it is MY DUTY to help them to the best of my ability. It is

my duty to give them correct information - and if I choose to do so at my group

because they are so tapped out on $$ after spending several hundred dollars on

others who did not help...then that is what I am going to do. To do otherwise,

to restrict information, to NOT help without filling out stupid forms and doing

individual consults etc., etc. blah, blah, blah would be reprehensible for ME.

I could not look at myself in the morning if I didn't. Why? Because that is

what my personal code of ethics tells me to do. Help - even when I don't get

paid. Help when they need it if at all possible. Refer to the appropriate

people as needed, talk to the Dr if needed - but HELP them because quite frankly

- I am often the only one who has been able to answer their questions.

So - there you have it. I think that we are responsible to do what we feel

works for us and our personal code of ethics as well as what feels right to us

to help moms. If it feels right to see them for free - do it. If it feels

right to give them info at a group - do it. Follow the SoP - yes. But we must

help the moms...and there is a way to do that and follow the SoP too.

Warmly,

Jaye

November 18, 2011

Read with sarcasm: I do not consider tongue tie awareness a diagnosis. I say " oh, look at your baby's tongue tie, it is a type __ " just like I say " oh look at your baby's nice smile " or " nose " or " hair " or whatever. I feel very safe in this because after so many years and thousands of instances of doctors telling moms there is no such thing as tongue tie, tongue tie is not a problem, it does not impact breastfeeding, and it does not need correction it seems to me that there is no reason to call it 'diagnosing'. I actually also say, " oh look, just like you " when it is mommy or daddy they get this cute little non medical issue trait from. Sheeze.

Back to normal voice:Jaye, you are not alone at all! And if there was a 'like' button on Yahoo I would like your posts quite often! I put my babies and mommas first. I understand that there are other goals and plans that have to do with the license of the field, etc. However, when those things impact my ability to provide ethical care, I will choose the care. And since it will not happen that all states will adopt the requirement to license to help with breastfeeding, I am not overly concerned about my future either. Jaye, quick, go trademark that label. I will use it too. I like it. I may just start using it now.

Pam MazzellaDiBosco, IBCLC

November 18, 2011

Yes, Ladies, I never diagnose, whether at a home visit, hospital visit, or support clinic situation. I just show mom and dad, if available, what I see, explain some of the possible issues that this could or already has led to, refer out to a TT friendly ENT or ped, and follow-up to see if she has decided to take the advice. I once had a mom who refused to even have the baby's tongue looked at by the MD father's colleague but continued to call and want to schedule appointments. I told mom after the initial visit that I could not ethically charge her again to see her or to attempt to 'fix' the latch when I knew in my head and heart what was going on with this baby's oral cavity. I don't think she was too happy but I can sleep at night knowing that I did not take advantage of a situation even if she could afford 10 visits. My motto is: We reap what we sow " and I'm not sowing bad seed.... Thank you Ladies for the engaging talk, Caruso BS, IBCLC,RLCA Mother's Friend CompanyLake Worth, Florida

November 18, 2011

But (and you can all scream at me) would you feel differently if you were a RN like myself? We cannot diagnose (which I don't do), dispense medications or really do anything freestanding. Having a license to protect makes me a little more cautious. Anyone else? Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Friday, November 18, 2011 12:06 PM Subject: Re: Consents for Breastfeeding Support Group?

Read with sarcasm: I do not consider tongue tie awareness a diagnosis. I say "oh, look at your baby's tongue tie, it is a type __" just like I say "oh look at your baby's nice smile" or "nose" or "hair" or whatever. I feel very safe in this because after so many years and thousands of instances of doctors telling moms there is no such thing as tongue tie, tongue tie is not a problem, it does not impact breastfeeding, and it does not need correction it seems to me that there is no reason to call it 'diagnosing'. I actually also say, "oh look, just like you" when it is mommy or daddy they get this cute little non medical issue trait from. Sheeze.

Back to normal voice:Jaye, you are not alone at all! And if there was a 'like' button on Yahoo I would like your posts quite often! I put my babies and mommas first. I understand that there are other goals and plans that have to do with the license of the field, etc. However, when those things impact my ability to provide ethical care, I will choose the care. And since it will not happen that all states will adopt the requirement to license to help with breastfeeding, I am not overly concerned about my future either. Jaye, quick, go trademark that label. I will use it too. I like it. I may just start using it now.

Pam MazzellaDiBosco, IBCLC

November 18, 2011

Actually, it's why I chose not to be a nurse. AND it's why I am NOT happy with the push to put IBCLCs in the same boat tying our hands and shoving a gag down our throat so the almighty status-quo can continue. I totally understand your position. It really does change things and I know that. Like I said to a doctor not too long ago: This is the 2000s and women can read. Even if I refuse to tell them, they can still read.

Pam M.

November 19, 2011

you're not being an RN you are being a LC Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Consents for Breastfeeding Support Group?To: " "

< >Date: Friday, November 18, 2011, 1:09 PM

But (and you can all scream at me) would you feel differently if you were a RN like myself? We cannot diagnose (which I don't do), dispense medications or really do anything freestanding. Having a license to protect makes me a little more cautious. Anyone else? Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Friday, November 18, 2011 12:06 PM Subject: Re: Consents for Breastfeeding Support Group?

Read with sarcasm: I do not consider tongue tie awareness a diagnosis. I say "oh, look at your baby's tongue tie, it is a type __" just like I say "oh look at your baby's nice smile" or "nose" or "hair" or whatever. I feel very safe in this because after so many years and thousands of instances of doctors telling moms there is no such thing as tongue tie, tongue tie is not a problem, it does not impact breastfeeding, and it does not need correction it seems to me that there is no reason to call it 'diagnosing'. I actually also say, "oh look, just like you" when it is mommy or daddy they get this cute little non medical issue trait from. Sheeze.

Back to normal voice:Jaye, you are not alone at all! And if there was a 'like' button on Yahoo I would like your posts quite often! I put my babies and mommas first. I understand that there are other goals and plans that have to do with the license of the field, etc. However, when those things impact my ability to provide ethical care, I will choose the care. And since it will not happen that all states will adopt the requirement to license to help with breastfeeding, I am not overly concerned about my future either. Jaye, quick, go trademark that label. I will use it too. I like it. I may just start using it now.

Pam MazzellaDiBosco, IBCLC

November 19, 2011

Pam,

Wasnâ€™t that Penny Simkinâ€™s famous like in the â€˜70â€™s?! When challenged by a doctor how could she possibly know something he doesnâ€™t (or didnâ€™t agree with) she answered with â€˜I can read!â€™ Things never change it feels sometimes.

Felicia Henry, BCCE, IBCLC