I wonder if it would be helpful to use the LC Core Curriculum as a basis for
this project as a starting point for competencies? There are a number of good
"guides" available as well such as the "clinical blue print from BSC" and the
modules from Vergie Hughes (LEConline?) and the lactation management module
from wellstart. The list that was posted earlier is a good one, too. I don't
recall if this was for those just in a hospital (as RNs) or those who see babies
later, too. When I work with staff, I have tried to focus on the differences
in the first few days (colostum suck patterns, the importance of latch,
differences in output) and what to expect for the rest of the first two weeks when
teaching/modeling discharge information needed for the breastfeeding mom. I have
a one page sheet that I use to orient nurses and teach students. Of course
the biggest challenge is getting the nurses to come to us for this
training....i.e. inservices or on their own time. I realize this topic refers to a "Course"
that I assume would take weeks or months. Or a workshop of several days?
My "dream list" would include the following - and this could be for a
specific hospital or a general course.
Review of Hospital Bf policy, Breast and nipple assessment (history and
exam),  Anatomy & physiology of lactation, Properties of colostrum and milk supply
initiation (including when and how to pump if needed). Effective initiation:
i.e. delivery room feeds, baby feeding cues, first day(s) sleep/feed patterns,
latch & positioning, expected intake and output. Challenges in the first 24
hours, i.e. no latch, when to supplement and ways to do so. Anticipatory
guidance: engorgement, sore nipples, maternal medication needs, growth spurts. Mom
problems: c/s, inductions, toxemia/hypertension, epidurals, infectious disease,
diabetic (GD or IDDM). Baby problems: premies, "just a little early (34-37
weeks), hypoglycemia, jaundice. Most of what I've listed is general - don't know
if you want to include cleft, cardiac, down syndrome or other baby situations
or go into plugged ducts, mastits, thrush......
Good topic, let's talk more about this.
Mary Kay Smith, RN, IBCLC
Canton MI




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