Laurie, an interesting and revealing picture of what you have to tackle. >Breastfeeding rates are >quite low, especially bf continuation, and moms usually return to full time >employment at 6 wks. That *in itself* is just awful. Full time? At 6 weeks? > Yesterday my case load was thus: >1. 35 wk infant feeding fairly well, experienced mom -- going home on day 2, >should do well -- will get early followup visit. >2. 35 wk infant, primip, not eating well at all; going home anyway on day 2. >will need followup - pumping - etc Can't believe these mothers would be going home on day 2 - with a 35 weeker?? Here, there would be no question of mother and baby spending anything less than 1 or even 2 or even more weeks in the hospital with a baby born as early as this. And then at home, they would get regular follow up from the community midwife and possibly visits from liaison staff from the hospital, esp if the baby still has problems. These visits from the midwife might be daily (though not in places like London where there is a shortage - but they wd still get phone calls and visits maybe every other day). >3. infant with respiratory distress and probable sepsis, in special care >nursery on oxygen, IV, antibiotics >4. infant born at 34 wks gestation, mother with insulin dependent diabetes >and PCOS, skin tags, hirsutism >5. 34 wk infant not gaining, came in for 48 hr followup, ineffective, >lenghty feeds - yes pumping too but mom decided to do more bf. >6. antenatal visit with mom with infertility x 6 yrs; PCOS All of these are way beyond the scope of a volunteer - but the volunteer can still be involved as a listening, supportive friend, and does something *different* from the specialist. > >Would peer counselors or LLL Leaders be comfortable totally "managing" these >mothers and babies? Without a physician conferring? I am truly curious >because I realize every country and culture is different and healthcare >systems are vastly different. I think you are right to note this difference, Laurie. We get a lot of stuff wrong in the UK with regard to birth and aftercare, but the system is in place to have routine medical/midwifery care at the point of need, and mostly, women are encuraged and supported to bf, though the knowledge and skills to make this a reality are sometimes lacking. However, even the mothers and babies on your list 3, 4, 5 and 6 are still having their medical care managed - and the role of the LC would be to liaise with the carers to ensure bf is still supported. These mothers will still benefit from peer or volunteer suppport, alongside the medical and clinical knowledge you bring to their care. > Or do you think an LC with didactic and >clinical experience with sick moms/babies would be useful. Very!! It's not an 'either or' but a 'both'. Heather Welford Neil NCT bfc, tutor, UK *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html Mail all commands to [log in to unmask] To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or [log in to unmask]) To unsubscribe: unsubscribe lactnet or ([log in to unmask]) To reach list owners: [log in to unmask]