Aargh!  I am so frustrated with going to call after call to deal with moms &
babies who are essentially hindered by nipple confusion.  Our local hospital
has a policy against using any type of alternative feeding methods, including
dripping milk onto mom's nipple to facilitate latch on.  If a baby is not
"going to the breast often enough", he gets fed ABM by bottle.  There is no
electric pump on the floor.  Every baby gets a bottle of D5W at delivery
before being allowed to breastfeed.  Every baby has a nurse "teach" him to
use a pacifier.  Babies can be in mom's room only during the day.  Is this
the Dark Ages, or what?

When I tell these moms the pacifiers and bottles are probably interfering
with breastfeeding,  they are shocked.  They've never heard this before.  It
is not unusual for me to get a call after the baby has been bottled for a
week; once the mom called at 7 weeks and was now ready to try b/f.  Some of
the local peds are good (that's how I get called into the picture), but most
have the attitude that unless we have a vigorous baby and a dedicated mom,
breastfeeding won't work.   Frankly, the emotional stress of dealing with
these moms as the light bulbs go off & they realize they've contributed to
the problem is getting to me (and I just had a vacation!).

My perception is that, while some babies do go back to the breast after
several weeks, overall these are not the moms who would walk over hot coals
to b/f.  Since they were willing to use a bottle initially, it is easy for
them to give in & use one at 2 a.m. when I'm not at their side.

Besides wanting the opportunity to blow off steam (thanks!), I'm wondering
how other LCs working in the community deal with nipple confusion.
 Realistically, how many of these babies can I expect to go back to the
breast?  Has anyone had success changing hospital policy from the outside?
 Does anyone working in the hospitals have ideas on what I can do besides
just mopping up?

Don't know what I ever did without you, my sisters in b/f.

Fried, but not quite burnt,
Ro Andersen, IBCLC
Winchester, MA