Hi all, I'd like to second Carol and Kathy's posts (beautifully stated, by the way) and add my two cents.  Sometimes it upsets me to read about another NICU which is being berated for "breastfeeding problems".  I think that it is far more constructive to work within the system to create change, than to criticize.  I work in a NICU which has held 70 babies and has a staff of about 180 nurses.  For the most part, these nurses (and doctors) are extremely intelligent, caring and sensitive to the needs of their patients.  In most groups, there may be a bad apple or two or three...but, as I told my manager(who is not the manager of the NICU), "These are not maternal-child nurses--they are pediatric intensive care unit nurses."  That means that they are used to measuring intake and output, daily weights, taking frequent vital signs, increase IV drips and decrease them accordingly.  In other words, they are very intuned to numbers.  On the other hand, they teach parents how to care for  their babies, hold their hands when a bad diagnosis is made or hold them when their baby is dying.   Over the last four years when I have been involved in promoting and supporting breastfeeding  in our NICU, I have seen fabulous growth and learning in the nurses and doctors. Ten of our nurses will be sitting the IBCLE exam this summer!!  Yes, I'm bragging!!  I am very proud of all of them.  Again, as I've said before, find someone within the system to create change in the NICU with breastfeeding.  Teach them how to do the teaching, teach them how to do the assessment of feeding at breast, tell them about the recent research--as I said, these are highly intelligent people, they'll catch on, and when they figure out it's not brain surgery, they'll do just fine.
                          Maureen Allen RN, BSN, IBCLC
                          Brigham and Women's Hospital
                          Boston, MA

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