To: Richard Weston, and all
From: Janet Thurston RNC, IBCLC
Re: Breast pumps, Hospitals, Rental Stations and Medical Records
A recent Lactnet post inquired about handling of medical records.  In our
local hospital lactation program, the use of the medical record initially
started out as scraps of paper.  We soon realized that something had to be
done about to incorporate the documentation of phone contacts and outpatient
/ inpatient visits.  In patient of course just involves utilizing the
current charting system.  Any LC would be wise to consult with a medical
record specialist to learn more about designing a medical record system for
their practice.  Most hospital based medical records departements are happy
to assist.  I would love to see JHL or other related newsletters address the
issue of LC documentation and medical records archiving.

Related to Breastpumps, I heartily agree with Richard Weston's post.  Here
in Alaska, in 1993 research from Ross, WIC and other programs indicated that
the reasons women in Alaska quit breastfeeding were first "not enough milk"
and secondly "return to work" (we have almost a 90% initiation rate".  From
the perspective of quality improvement, these issues were targetted locally.
We began to offer breast pumps to moms in the hospital, with education and
follow up.  Our breastpump station went from having 10  pumps to 80.  Alot
of folks had the feeling we were promoting technology rather than mother
baby togetherness etc.  The fact is, women who wanted to breastfeed were
quitting because they did not have the skills or knowledge on how to return
to work, access to crappy pumps available in our stores (you know the ones,
the little bicycle type etc).  On the bottom line, we addressed these issues
based upon RESEARCH.  We documented the rate of breastfeeding initation,
duration and reasons why women quit.  We address those using the breastpump
and education on expression.  In 1995, we no longer see "not enough milk" as
a reason for quitting locally based upon WIC surveys.  Feedback from our
rental station mothers indicated a 99% satisfaction rate!  Women stated they
were breastfeeding much longer because of using breastmilk supplement rather
than formula.  I think the formula companies know this and we need to give
supplementing moms another option- to use their own LIQUID GOLD.   We have
three LC's at our local WIC (which dispenses free pumps) and they all
heartily agree that the pumps have been a good thing.  For our  moms, breast
pumps have increased duration rates.  Our peds tell us that they hardly ever
see FTT with breastfeeding anymore.  Women have the tools to maintain supply
if the baby can't latch, several wt check clinics and follow up programs.
The point is, its working.  We still need to press on to make work
environments more baby friendly.  That is the greater mountain we have yet
to climb.  I would encourage all L.c.'s to connect with local WIC programs
and find out why women discontinue breastfeeding and then target education
programs to address improved outcomes.  Like I say to laboring moms, "you
can do it . . . you are doing it. . . .just keep going!"