Lynn writes: Both had consulted with the hospital based =
LC and
felt that since they had *already seen a lactation specialist*, all had =
been
done that could possibly be done.   Needless to say, it required much
*convincing* to set up a consult.
To all hospital based LCs- please discourage parents from viewing you as
their last chance to making breastfeeding work. Most parents that I see
haven't absorbed the concept that breasts and babies change from day to =
day
ie. what doesn't work one day, may the next OR they have no idea that =
there
can be vast differences in approach/experience etc, between individual =
LCs.
More often than not, according to them, MY teaching is very different =
from
the last LC they saw!

Lynn, We often don't get things totallly squared away in the hospital and
always offer follow up to our mothers either at our outpatient lactation
clinic or with an LC in the community. We seldom start shields in the
hospital for full term infants because it is very difficult to evaluate how
they are working before milk comes in. In the rare instance where one is
started, mother must agree to come back for follow up. We all also have to
realize that the situation we see in the first 48 hr.in the hospital is often
quite different several days down the line. We are well aware of this in our
hospital because as well as our in patient service, we have a very busy
outpatient lactation clinic. The 7 LC's staff both in-patient and out-patient
areas.  When things are not going perfectly at discharge,  we explain that
getting breastfeeding established is process. As things change we change the
plan. When mothers understand that the priority is to feed the baby in the
way least detrimental to breastfeeding while protecting the milk supply, with
an ultimate goal of establishing good feeding at the breast, they are
wonderful partners in the process. I hope no hospital LC tells a mother that
the consult they receive in the hospital is the end of the help available for
breastfeeding. What mothers think they heard or want to believe, however, may
be a different story.

Kathy Boggs, RN, IBCLC

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