Dear Friends

A dilemma.  In 13 years of private practice I don't think I have given out
more than 5 nipple shields.  In retrospect, there may have been another
couple of cases early on that could have benefited from shields.

I now have a part time lactation post in a local hospital where shields are
commonly used.  I would like to draw up guidelines for their use.  This is
not the individual approach that I favour, but it will need to be a
compromise for now.  Skin-to-skin care is beginning to be accepted and has
definitely "saved" a few babies from the nipple shield.  The acceptance of
cue-based feeding is proving to be frustrating, but I am working on that
one.  The same for asymmetrical latch and effective positioning.

Reflecting on almost one year of hospital work I realise what a tricky
balancing act it has been.  It is extremely frustrating to come from an
evidence-based practice into a hospital situation.  I feel like I am walking
on egg shells much of the time.  Thank goodness for Lactnet!

Jean Ridler  RN  RM  IBCLC
South Africa    [log in to unmask]


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