Dear all:
I haven't completely followed the thread on teaching nurses about breastfeeding, but I've skimmed 
enough to feel like it is a very important idea.  However, this approach only addresses the very 
initial piece of breastfeeding.  For our profession to have an optimal impact we MUST recruit those 
who interact far longer with women than during the first few days in the hospital - nutritionists, 
speech and occupational therapists, social workers and psychologists - and, of course, it goes 
without saying our original support system for breastfeeding La Leche League leaders.  

I see a huge problem that could be readily tackled by those who are training nurses in hospitals.  
You have a fresh start to create a group of professionals that would start the link with private LC 
who work outside the hospital.  This link is extremely necessary.  We who work outside the 
hospital often get the train wrecks and mom's version of the story but really have no idea about 
what really happened.  Often we end up having to switch the initial strategy to something else 
because we see an entirely different picture on day 4 or day 10 or day 14 or 3 months, etc.  It 
would help our knowledge to know what was attempted and was what observed initially so that we 
could better tailor our strategies.  

On the other hand, it would benefit those who work in the hospital to get information about how 
those initial strategies play out once mom gets home.  Which mothers and babies actually benefit 
from that bit of cup or spoon feeding in the hospital and which turn out to have the protracted 
problems where the cup and the spoon end up in the garbage can in a fit of frustration?  Which 
mothers go on to latch well with a 16 mm nipple shield and which go on to have a low supply and 
minimal milk transfer because they really needed a 24 mm nipple shield or perhaps, plain and 
simple someone who could spend a few hours with them working on latch rather than some 
hospital allotted time period because there were too many women to be seen and not enough 
skilled nurses and IBCLCs?  How many starter SNSs get clogged up and don't work and end up in 
the trash after the baby drops weight and mom gets frustrated and how many provide the day or 
two of help and mom and baby go on to do well just breastfeeding?  How many women do you see 
with the suspicion of insufficient glandular tissue or breast reduction surgery who may very well 
go on to do well or need a little encouragement that they are breastfeeding even if they do not 
have a full supply ---- and there is no way for you to figure it out during their hospital stay.  

I can think of a zillion questions that crop up from the void between hospital and home that could 
begin to be addressed by building a bridge between hospital and private LCs through nursing 
classes.  Consider getting the private LCs in dialogue with you for the courses - I think both sides 
would benefit enormously.  And of course, now I'm thinking of the WIC clinics that may have some 
IBCLCs or nutritionists that could begin to build those bridges.

Breastfeeding is not just the first few days in the hospital, it is a relationship that starts there and 
continues to need nuturing at every step along the way.

Best regards, Susan Burger

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