Marie,

I most want the RNs in my hospital to know when a family needs referral to
an IBCLC. Also, when they don't. For instance, a sleepy baby at less that
twelve hours of age is not a reason for an LC referral...it is something a
baby is likely to get over on his own. Any RN can care for this baby and
mom. All that is required is some skin to skin contact, some patience, and
some parental reassurance.

On the other hand, a baby should not go home being supplemented without the
LC doing some follow-up. No matter what the reason...supplements are a
cause for concern because they can lead to inadvertant weaning.

I like Linda Smith's conceptual model for Lactation probs. and when to
refer to whom. It is called ABC protocol and is copyrighted by Linda. I
learned about it at her course "Why Johnny Can't Suck" and i use it as the
basis for my RN ivsvces.


I guess beyond this, and what you already mention...I try to teach them how
to use alternative means for supplementation. i try to help them understand
the rationale behing cup feeds, SNS feeds etc.

Susan

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