Another of those "confounders":

Out Maternity assistant supervisor came by with a very real concern.  We have
two breastfeeding educators, each has been selected by the supervisors of their
departments due to her interest in bf.  They have been educating patients on the
floor and helping moms - then having me see the mom if the problems are
complicated.
Well, the supervisor  thought that perhaps one of the educators wasn't doing as
well, as the moms on "her" side were having much more trouble latching babies
on.  Well, after "investigating" the situation I found:
        This educator tends to do  less "hands on" and more "support and educate"

        The moms were very pleased with her help and support
        She's the "grandmotherly" type, less "interventionist"

Having been an LLLL for "almost" (May) 20 years, I really believe in people
doing "their own thing," as moms respond to different types of people - and the
more the variety of personalities working with bf moms, the more likely we will
find someone who "clicks" with that particular mom.

BUT the "real" difference, was that the side of the floor she usually works has
the private pay patients with private rooms - who also are more likely to have
paid (no insurance coverage unless c/s) for the Epidural!

My latest problem baby was with a lovely couple who did everything "right"
prenatally - classes, read, etc.  Delivery was with epidural, circ was done less
than 24 hours after delivery before baby had ever latched on right - and I had
to finger-feed and teach them to do so as discharge was this AM.  SO
FRUSTRATING!!  His tongue was totally "discombobulated" Yes, I know that's not a
scientific word, but it fits!  He had no idea what to do with a breast - or a
finger - in the mouth.  By the time they left I had him moving the tongue
correctly maybe 15% of the time - not enough to grasp, suck and milk the breast.
I urged "rebirthing" and self-latching attempts rather than trying to be too
interventionist - but also gave them Dr. Parrilla's number in case things don't
improve in next 24 hours.  Meanwhile, "feed the baby" (in whatever way they felt
they could, as I taught them finger and cup feeding)  and "pump" were the
instructions.  I'm sure the Ped. will keep me informed...  (Would this mom be
considered part of the 5%?)

Luckily, today I also had the priviledge of helping two NICU babies latch on
(beautifully) and talk to three young 7th grade girls who are doing a school
project on breastfeeding. That was really fun!

Jeanette Panchula, BSW, LLLL, RN, IBCLC
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PS, one of the supervisors is asking me if there is a test we could use to
identify a "basic knowledge" for the breastfeeding educators.  Any suggestions
on sources for this?  TIA