Dear Lactnetters,
I really need some help--and in a hurry!
There are three of us IBCLCs who work in a hospital setting. We have about
1000 births a year and about a 60+ % breastfeeding rate--and growing. We
see the mother-baby dyads in the hospital as "inpatients", and then again
two days after discharge as "outpatients" for a breastfeeding assessment.
All was going well.....parents reassured and delighted, physicians
madeknowledgable about the baby's condition and any interventions
necessary..
Now, it turns out that our boss has been told that the hospital will no
longer receive insurance reimbursement for the majority of
those "outpatient" visits. In fact, it seems that all of the breastfeeding
moms will first receive an in-the-home VNA visit. If there are any
breastfeeding problems, then they will be referred to us.
These VNA nurses are great, but they are not IBCLCs and will only receive a
short training session on breastfeeding from us before this program is
launched.
Our boss did suggest that we might be able to do the initial outpatient
assesment of mothers with "breastfeeding issues" She could not define that
very vague term and asked us to.
What I am asking you, is what would you consider an "issue" that merits a
real, genuine bonafide IBCLC?? To me, just about anything can so easily
become "an issue" : sore nipples, poor latch, engorgement, weight loss,
twins, etc. etc. etc. Does anyone else have a similar program that does
receive reimbursement? Can anyone give me some research articles that might
help to support or present services? I worry that the moms will not get
enough support; that they will give up breastfeeding; that babies might
have to wait to be seen by one of us--when there is already some trouble
brewing...
And why the urgency?? Because our deadline is in two days: come up with a
definiton of "breastfeeding issues"!
Thanks for any ideas, encouragement or insight!

Kirsten

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