I have been a private practice LC and I have had a personal pump rental business. I have been, and currently am, a hospital based LC. While it is true that many moms do not receive the help they need in hospital, and while it is true most hospitals in my geographic area (and others) are woefully deficient in breastfeeding support, most LCs are quite capable and caring. I talk regularly to other hospital based LCs. All of them are quite frustrated and overworked. For example, at my hospital which does about 100 deliveries a month, I am the lone LC, in fact you could say that I am the "breastfeeding program." And I work only 3 days/wk. It is management's decision not to hire additional staff. At another hospital the LCs there may have 20 mothers to see in a 6 hr allocation. Their hours and their services have been curtailed. this caseload would includes several sick/nicu babes to work with. They are told they must clock out after 6 hrs. They have been told to discontinue f/u calls and consults. They have to prioritize. Many LCs at several hospitals REGULARLY clock out but stay hours afterwards to make sure the moms get the help they need. I take calls at home regularly and on my off days and weekends, gratis. When we LCs are together for affiliate mtgs, for example, we are always talking about our frustrations, about how much we have to do, but there are so many constraints and barriers. Many of us are quite experienced and competent. I am not aware of any private practice LCs in New Orleans that I could refer to. We do have a private practice LC about 100 miles away. I'm sure lactnetters realize that just because an LC works in a hospital and only gets to see a mom for a snippet of time, this does not mean that the LC is not highly qualified. Re the pump rentals and sales: It is critical to examine the ethics of this at all times. I appreciate the discussion on this. However if the hospital has an LC and pumps and gives out other pump competitors ph.nos., it does seem quite convenient to hire the pump right then and there for a premie, say, and have the LC come to the room to demonstrate it's use, instruct on cleaning, storage, labeling, transport, provide written instructions, help mom pump and then label the milk, etc. I myself have done this at other hospitals where I worked. I myself have paid a little more, say for a gallon of milk, instead of driving an extra 10 miles to save a 25 cents. I realize moms are vulnerable at that time in their lives, but if the price is fair and the service good, I am not seeing this as an ethics breach. Appreciate the debate. Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA _________________________________________________________________ The new MSN 8: smart spam protection and 2 months FREE* http://join.msn.com/?page=features/junkmail *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html