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Leader/Lactation Consultant: Separating the Two Roles

Gina Wellner-Weissman
Moshav Be'erotayim, Israel
From: LEAVEN, Vol. 34 No. 4, August-September 1998, pp. 84-85

Being a Leader is a labor of love, for, as a volunteer, there is no financial compensation. Sooner or later some Leaders look for paid employment in addition to, or instead of, their volunteer work. Because leadership has been so rewarding, some Leaders put LLL experience to use earning money by becoming an International Board Certified Lactation Consultant (IBCLC).

A Leader who becomes an IBCLC may wonder whether she can comfortably integrate her profession with her volunteer work. Can she combine the two or will it be necessary to retire as a Leader? This could be a heartrending decision; retiring is a loss for LLL as well as for the Leader.

LLLI has developed guidelines clarifying when a woman is working as a volunteer Leader and when she is working as a paid lactation consultant (see box). Since this is LLLI policy, a Leader agrees to abide by it when she signs her Statement of Commitment.

If a Leader decides to combine the two positions, there are matters that she needs to deal with to avoid confusion as to which "hat" she is wearing. More often than not the Leader/IBCLC has only one phone available for her work. When a mother calls, it may be difficult to determine whether she is calling the Leader or the lactation consultant. The mother may not be aware that there is a difference. Even if the Leader/IBCLC carefully explains this to the mother, it is doubtful during a stressful situation that the mother will comprehend these details.

It may be more helpful to ask the mother a few simple questions. A Leader may begin with, "Yes, I do counsel mothers who have difficulties with breastfeeding and I'll be glad to help you. Before we begin, may I ask where you found my phone number or how you knew to call me?" Even a distressed mother will know that she phoned LLL or that she saw the number on a flyer or that her birthing clinic referred her.

If it does not seem to be an LLL call the Leader could confirm this by asking, "Are you calling to speak with a board certified lactation consultant who will expect to be paid for her services?" Asking the right questions can often clarify things for the mother as well as the Leader/IBCLC.

If she only has one telephone line, the Leader/IBCLC may consider using it for her lactation consultant business and inform other Leaders in her Area that she can no longer take helping calls as a volunteer Leader. She could take a leave of absence, go on Leader reserve or continue to contribute to LLL as a volunteer by leading Group meetings or taking an administrative position.

In my dental practice, I try my best to keep my patients informed. I describe benefits of the treatment, the likelihood of pain and any postoperative instructions that need to be followed. As a health care professional, I write everything down. I rarely explain these things on the phone; I nearly always explain things face-to-face. Yet I have found it amazing the number of times I explained an issue and the patient heard something entirely different. This is almost certain to be even more of a problem on the phone.

As Leaders, we are aware that from time to time misunderstandings occur when information is shared with a mother. Leaders are required to keep a log of their helping calls and home visits. This is the record they will have to fall back on should a problem arise.

Using the same phone for both LLL phone helping and lactation consultant work makes it much more difficult to keep the roles separate. No matter how clear we think we are, explanations can be confusing to the mother. The difficulty is that if a mother calls and does not understand the difference between a Leader and a lactation consultant, she might end up thinking that the Leader charges for her services and La Leche League is not a volunteer organization. The consequence is serious. LLLI risks loss of its nonprofit status.

It is very important for a volunteer to keep her volunteer work separate from her paid work or practice. When health care providers do volunteer work, they often work in another area of medicine or in a situation completely different from that in which they practice. It is unethical in the medical community to refer a patient to oneself and say, "Under the auspices of my volunteer work I can't help you, but if you come to my clinic you can be taken care of for such and such a fee."

Another area of concern is the issue of home visits. If a Leader/IBCLC decides to do phone counseling as a Leader and realizes there is a need for a home visit she should be prepared to:

  • Do the visit as a Leader.
  • Refer the mother to a list of Leaders who do home visits.
  • Refer the mother to another IBCLC.

It may certainly be possible for a Leader to wear both a Leader and a lactation consultant hat as long as it is clear in her mind when she is wearing each. She would need to clearly distinguish between a phone call made to her as a Leader and a call made to her as a lactation consultant. She must have a clear understanding of LLLI policy and her commitment as a Leader.

LLLI Guidelines for a Leader/Lactation Consultant

  1. An active Leader/lactation consultant cannot make referrals to herself for pay.
  2. An active Leader/lactation consultant cannot advertise herself as a lactation consultant on LLL phone recordings or at LLL Group meetings.
  3. The Leader discount on purchasing materials from LLLI is intended to produce revenue for the local Group or Area and LLLI. The Leader/lactation consultant is expected to return such profits to LLLI, her Group or Area. However, she may purchase materials at a commercial bulk rate and retain the profit as any business may do.
  4. A Leader/lactation consultant using LLLI materials and resources to help a paying client is expected to reimburse LLLI for the cost of those materials or resources, or make a donation to LLLI, her Group or Area.
  5. A Leader/lactation consultant may advertise in written LLL materials or exhibit at LLL functions to the same extent as other individuals and organizations that promote breastfeeding and offer breastfeeding information and support. Free exchange of information promotes cooperation and harmony, and benefits everyone in the long run. Exclusion promotes lack of cooperation.

LLLI Board of Directors, Oct 89
PSR Appendix 21

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