As I do more home visits for clients in my area who have given birth where I
work prn on L & D, I am finding several disturbing things.

1.  They do not know how to assess what is going in or out of the breastfed
baby.

2.  They are not demonstrating proper latch or positioning at the breast.  I
am seeing lots of sore and traumatized nipples and engorgement from the baby
nipple feeding instead of breastfeeding.

3.  They are telling me that *IF* they received any BF instruction during
their hospital stay, the information they received was often conflicting
from shift to shift.  And no one is watching them through an entire feeding.

There is no L.C. where I work.  It is up to the nursing staff to educate
parents about breastfeeding.  Fortunately, some of our patients go to a
prenatal breastfeeding class or La Leche League meetings to learn the basics
beforehand to offset the conflicting or inaccurate info or practices they
see in the hospital (like using bottle nipples for nipple shields).

We have seen improvements in our initiation rate but that rate goes way
downhill by the time they make it to a well baby check in 3 weeks.  Yes, you
read this right-3 weeks.  It is supposed to be 2 weeks with a follow up
phone call by 72 hours postpartum.  But there are not enough appts.
available to see these babies at two weeks.

I could elaborate here but I won't.  My point is that as a nurse who works
in the hospital setting, I believe it very much is my responsibility to
provide current and consistent education to breastfeeding families, if for
no other reason, who else is going to do it in facilities without LCs!?

Maurenne Griese, RNC, BSN, CCE, CBE
Manhattan, KS  USA
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http://www.networksplus.net/griese

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