I would now like to thank all those who gave Laurie Wheeler so much support.
I would have liked to add my encouragement to you as well Laurie. As I said
in an earlier post, I just seem to function from crisis to crisis, due to
the many changes that have occurred in the last 3 years. Breaking my pelvis
two years ago didn't help.

Just as we had become excited about being able to offer breastfeeding
support 7 days a week, last week Thursday yet another thing was tossed our
way. Since we now have one full-time (me) and 3 part-time LC's on staff the
powers that be, said that we are now way over budget in the BF clinic. This
is not what our "workload measurements" shows.

We have been asked to start doing prenatal assessments because the Ontario
government will give money for anti-natal support. Management feels that
this will offset the budget deficit.
We do think that it is a good idea because we will than be able to do a lot
more prental teaching about breastfeeding. That is not the problem. The
diffculty lies in the fact that they made the suggestions on last Wednesday
and Thursday and wanted us to start implementing this Tomorrow. Needless to
say my already overloaded mind broke me down in tears. We haven't even
solved our other problems and now they want us to do more. We get a new
Director in two weeks and haven't had a nurse manger for about 6 months
while our staff turn over has been about 3/4 in the last year, many of whom
have had know BF. experience.

Which battles should we fight first?

1. supplement premis with bottled EBM or not. Not all patients have as much
energy or support, right after birth to fight the battle. (I do often
suggest giving bottled EBM after breastfeeding, because babies than do get
discharged earlier and mothers do not have to go back and forth so often.
They just can't all commit to what Teresa's daughter in law was able to do.
We do get them to fully breastfeed generally by the time , or just before
they were meant to be born.) This keeps the stressed mothers from at least
being persuaded to use formula by their Doctors because they look so tired.
2. What kind of supplements should we give if medically indicated?
3. No separation of mothers and babies, even after C-sections.
4. or returning them back to their mothers to breastfeed if blood sugars are
low
5. Are glucometer tests causing the problem of hypoglycemia.(tongue in cheek
a little bit)
6. What is jitteriness? and is that the only critera needed to a BS heal
prick
7.  getting the protocol revamped
8. teaching staff.
9. How much supplement is enough or too much for premis or newborns if they
are fed more frequently.
10.Thankfully the treatment of jaundice isn't a big difficulty.

Thankfully I spent about an hour on lactnet archieves Friday night and
started reading all your supportive replies to Laurie. This was incredibly
helpfull. Management just does not see the whole picture. It is just facts
and figures. Breastfeeding is still seen as a frill. They do not see that as
we gain access to all these wonderful anti-natal moms and and give them
support that postnatally the clinic will be even busier.

I've just been told once too often that we should manage our appointments
better and be firm about who we see and how many. Babies do not feed by
appointment and breastfeeding difficulties I cannot turn away. I will also
not stop seeing clients at 6 weeks or 3 months or some such guideline. If we
are to protect, promote, and support breastfeeding for one year and beyond
we need to support them through all stages.

The length of this email probably indicates signs of burnout however the
things I have discribed are probably not new to most hospital LC's.
Please contiue to give your ongoing support.
we couldn't do it without you all!

Great Hugs and Happy 2002
Attie

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