We have a new birth center manager, plus our hospital is using a 
consulting firm to examine everything we do and make improvements.  All 
well and good.  However one of the latest requests is that we should 
have lactation protocols so we're all giving the same advice.  There are 
six part-time IBCLC's at two hospitals.  Maybe I'm just getting old, but 
this boggles my mind.  These are not hospital breastfeeding policies 
they're talking about, but protocols for giving advice--I guess like a 
"low milk supply protocol" or an "engorgement protocol" or a "weaning 
protocol."  I can try suggesting it, but I'm pretty sure they want 
something more concise than my saying that the Breastfeeding Answer Book 
or Breastfeeding and Human Lactation contains our protocols.  Do other 
LC's have anything like this?  Is there anything like this in print?  
After 15 years, my protocols are in my head and in a constant state of 
flux as I read new research and go to conferences!  Maybe I'm just too 
tired, but I'm having trouble wrapping my head around this.

Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin

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