On March 11 Linda posted, "I am also curious to see what the standard of
lactation care is at other hospitals."  I work at a growing hospital in
Austin, TX.  We have 2 full time and 2 prn.  We currently have 2 LCs on
Mon - Fri, 1 on Sat and sadly no one on Sunday.  We are about 300
deliveries per month and expecting to increase this year.  Our initiation
rates and still BF at discharge are similiar hovering in the mid 90's.  We
opened a store with rentals last month and added outpt consult M-F.  It
was a defensive measure to show profitability.  However it backfired when
we were denied a request for an additional FTE for Lactation. We are still
optomistic (naive maybe, but optomistic) that as we begin to help pay for
ourselves we may get that LC position.  We are getting a sales clerk and
that'll make life much simpler.

Daily:  We all BF primips generally trying to see them twice before
discharge then multips having problems, MD orders, requests for LCs.  We
see NICU moms in and out of NICU.  Occasionally paged to L&D (enough said
or it could turn into a tirade ;)  We offer Outpt consults during the
week.  We have been doing follow up calls for primeips and those
discharging with problems.  We did 3 initially 2days, 2 weeks and 6
weeks.  Because of time constraints, we are down to 2 day and 2 week.  We
have incoming calls to voicemail since we cannot have a live person to
answer.  All the calls are done or returned between patients. One of us is
dedicated for outpt visits unless there is none or they cancel/no show
then we go help on the floor.

Our struggle is educating the nurses and getting it to stick.  We get
paged alot for "sleepy babies", no feeds in 5 or 6 hours and panicked
nurses. Flat nipples (unnecessary shields to boot) seem to be epidemic.
It is frustrating not to be able to be in more than one place at a time!
It's a little better with 2 LCs on M-F we use to do it with 1 LC per day
only working 12 hr shifts but covering 7 days.  We had to give up Sunday
in order to have 2 on.

Despite all the frustration - still doing the work that I love.
From sunny Austin, TX headed out today for one of the longest running Kite
Festivals in the US.
Kathy Amell IBCLC

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