Babies with heart conditions often don't gain well related to a weak suck
and an increased expenditure of calories. I had a client who used a SNS and
an electric pump and never needed anything else. The baby gained well,
completely at the breast, with breastmilk, had her surgery and weaned off of
the SNS.

Several months ago, "Friends" did a show where everyone thought tasting
breastmilk was ok but the dad. I am not clear on the details anymore but it
was all matter-of-fact, everyone tasted it and gave their opinion. In the
end, the dad reluctantly tasted it, too. Unfortunately, instead of the 4 out
of 5 actors in the show thinking no big deal, in our society the reverse is
true.

Concerning the IBCLC req, because the exam is an entry level exam doesn't
mean that it is easy. Nursing boards are also considered entry level. I
remember thinking all this       " blood, sweat, tears and money for an
entry level exam?" It is just a term. Does any discipline give an end level
exam? I suppose if it was called end level that would imply there was
nothing else to learn. We all know that's not true. We need to keep high
standards or our field will not be considered a serious discipline. I went
through the same thoughts when deciding if I should be a lay midwife or a
CNM. I knew I could be a knowlegeable empirically trained midwife in a lot
less time and a lot less hassle than going to nursing school learning things
I'd have to unlearn and spending alot of money in the process. I don't
regret my decision to spend the time, though I've been going to school for
many years. I will be entering grad school in the fall and although becoming
a CNM doesn't mean I will be better than an empirically trained midwife it
does open doors for me and in the long run for birthing mothers because of
the credibility that carrying the title implies in our culture. I was a LLLL
before I was an IBCLC and an IBCLC before I was a nurse. There are ways to
get there. Volunteer work gave me the hours I neded to sit for the exam. I
volunteered in two hospitals once a week, seeing breastfeeding moms. I
stayed active in LLL, volunteered inservices in 3 hospital, WIC clinics and
health departments. I visited Drs offices and talked to staff, read, read,
read and attended as many workshops in bf and related fields as I could find
and afford. Keep fighting for the changes you see as just. In the mean time,
just do it. You might change your mind about some things along the way.

Pamela Koehler, RN, BSN, IBCLC, LLLL