Hello, everyone.  First I want to say that Lactnet has been a valuable
resourse for me as a new IBCLC.  I just passed the exam in 2002 and I work
as a staff RN on a Mother/Baby unit in a moderate sized city in "Middle
America". I have always been an advocate of Women and Childrens issues
having worked in Pediatrics and Maternal newborn for 25 yrs. Three Years ago
I became a CLC when our hospital decided to send 4 staff RN's to a 40 hr
workshop.  Perhaps the hospital just wanted to be able to say' "oh, yes, we
have counselors on staff.", because we have run into many roadblocks for
change in our facility.  Because there is not much of a staff turnover the
"powers to be"  have an attitude of "We've always done it that way".
     I have had to reset my goals for change regarding breastfeeding
policies by trying to make changes where it counts, especially with no
budget or separate lactation service.  I have concentrated on early latch
on, discouraging suppliments, staff education and maternal support.  All
this while working night shift!  At least I have the night shift taking out
the babies out on demand instead of every 4 hrs and there has been some
slow change in attitudes of the staff regarding supplimenting.  Physician
support is limited and I seem to get better response from the OB/GYN's than
the Peds.  The Peds would like to think they are pro breastfeeding but order
suppliments as soon as a mother says the baby nurses all the time!
     Right now I have taken up the project of redoing our breastfeeding
policy.  It states a baby may not nurse if a mother has a fever of 101. I
want to eliminate that from the policy.  I have taken a survey of area
hospitals and 6 out of 10 do not separate mom and baby for fever.  How else
can I present this to the peds since they are such a cautious group?  I
thought about showing the list of diseases compatable with breastfeeding
and mentioning that when a mom goes home she would'nt be separated from
baby if she had a fever.  This is only one of many changes needed.
Suggestions anyone?  Sorry this was so long.  JG

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