Dear Gail,
I agree, things are slowly getting better over the years. And it's not as if most of the nurses are any better. Most of what they learned about breastfeeding is often from 20 years ago and its wrong, but they are also often very resistant to change. IMHO. I recently was teaching some of our RN's about breastfeeding and they just cannot get past the idea of recommending scheduled feeding times. It's really been a fight to get them to stop telling patients to breastfeed every 2-3 hours and talk about feeding cues instead. I was told that "feeding on demand" was just a fad and the advice would probably change next week by one nurse. Schedules are just so ingrained in the hospital culture.

I do find more physicians willing to listen, too, however the problem really is the MD's are largely autonomous. You can make a policy change that the RN's have to follow, but it's hard to do the same with the MD's. You really have to get buy-in from them, which usually comes with education, which we usually can't make them attend. So we are stuck in this cycle. Recently, at an OB committee meeting I had an OB, who is actually a really nice guy, tell me that at this point in his career he doesn't know anything about breastfeeding and has no interest in learning. Oh, boy. It's always two steps forward and one step back.

Sincerely,

Tricia Shamblin, RN, IBCLC

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