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Thread: Scope of Practice???




Scope of Practice???
user name
2006-10-25 10:03:57
I am not an IBCLC, but I am a former LLLL, and I found these
sorts of restrictions insulting even for 
a trained volunteer.  We leaders regularly consulted each
other to develop new verbal gymnastics 
routines that would enable us to give women the information
they needed without overstepping 
our bounds, which did, indeed, often have us feeling bound
and gagged.  We could, for example, 
read Hale verbatim to a mother.  We couldn't, though, just
say to her that her doctor had been 
incorrect when s/he told her that ibuprofen is incompatible
with breastfeeding.  While I was a 
leader, too, there was an added push to keep leaders from
recommending any herbs, vitamins, or 
minerals. Yes, we could say, "many mothers find,"
and engage in all sorts of other semantic tricks 
that made us feel as though we weren't really daring to
impart solid, research-based, time-tested 
information and go so far as to suggest that these mothers
follow our recommendations.

And we had reason to fear reprisal.  The first time I ever
posted on lactnet, and identified myself 
as an LLLL, I had the unmitigated moxy to add to a thread
about co-sleeping.  My post, among 
other things, elicited other people's thoughts about how to
support mothers in light of new, 
scary-sounding recommendations that mothers never co-sleep
with their babies.  I quickly 
received a rebuke offlist from an LLLL who was, I guess,
supposed to police the internet for LLLLs 
saying inappropriate things. Even though my post was meant
purely as a conversation starter, it 
sounded to her too much like an LLLL admitting to ignorance
about a topic that had been covered 
in my training.  The message from this online liaison was
about as patronizing as anything 
anybody has said to me since I was six years old. 

And it shut me up for a long time.

I don't blame LLL, actually.  They have indeed suffered the
consequences of leaders making 
unfortunate and very public statements, and it is
understandable that they want to enforce 
standards for what can and cannot be said in their
organization's name.  I know there is ongoing, 
authentic conversation about how to do this while respecting
their leaders' autonomy.

But when I see IBCLCs being fitted with the same muzzle I so
resented a few years ago, I must add 
my voice to the chorus of dissent.  Letters behind our names
should not silence us.  If an LLLL or 
an IBCLC or, for that matter, an MD, gives bad advice,
spreads misinformation, or is unduly 
influenced by a profit-making entity, she or he should be
held accountable.  What kind of upside-
down world do we live in when those who are best able to
provide that accountability are told to 
shut up?  Regardless of our credentials, we are adults. 
Most of us live in free societies. We should 
be able to join in conversations, ask questions, express
opinions, share knowledge and, for 
goodness sake, help people.

It's not that complicated.

Kerry Ose, PhD, feeling solidarity with my IBCLC friends and
feeling happy that I can now say 
whatever I darn well please.

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