When I read the comment about putting breastfeeding back into the hands of
the mothers, all I could think is that we need to persuade mothers to take back
childbirth and then breastfeeding problems would be less common.  Those of us
who are hospital LC's are diligently trying to preserve breastfeeding many
times.   I sometimes practice preventive care in that I know I will be gone
during the night when a night nurse may offer formula to a baby who is too sleepy
to effectively nurse.  I may have a pump available and teach alternate feeding
just in case, always emphasizing that it most likely will not be necessary.
Drugged babies often do not nurse well.  We have lots of interventions that
must impact breastfeeding.

For supplementing, I mostly use the #5 French 36 inch feeding tubes which
cost a dollar, not $50.00.  They are easy to use and sometimes save
breastfeeding.  How do difficult deliveries, inductions, C-sections, etc. affect breastmilk
production?  I am not sure, but we have far too many women with little or no
colostrum easily expressed and babies getting a bit "dry."  I am convinced
there must be some correlation here.  When I give information about pumps, I am
glad we do not rent or sell, because no one can say we are trying to make
money.  I agree most LC's are not putting making money before good practice.

Judi Hall, RNC, IBCLC

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