I work in a large city hospital as a certified lactation consultant.
 We presently have:
    1. three LC's  (2.5 FTE)   We also have a secretary (who is more of an
administrative  assistant)  who recently was given full time hours.
    2. 7300/yr. deliveries
    3. Our hours fluctuate depending on who is working.  I am the person who
has the     most hours per week at present (.9) .  I work 8am to 5pm , four
days a week.  The   other two consultants work  at  the earliest 7am to 7pm
or a 9am to 5-6pm shift.    We cover seven days a week.
    4.  We cover the entire hospital.  We get referrals from NICU,PP,AP,
AICU, OBRR  and ER and sometimes the clinic.  We do phone calls and see out
patients by     appointment.  We do pump rentals and sales as well as bra
fittings and other misc.    sales.  We teach  prenatal breastfeeding class
and let doctors and nurses shadow   us for educational purposes.  We are
presently working on expanding our lactation    center to include a larger
boutique that will be a collaborative effort with the volunteers    who have
our hospital gift shop and the breast care/oncolgy department.  It is to be a
    women's boutique for new moms and women with breast reconstruction needs.

We also find it very difficult to get everything done in a day and usually
are working over our paid hours.  As you know it is very difficult to go home
when you have a mother who needs you or worse is crying on the phone.  There
is a tremendous need for our services and we are getting more and more
referrals but with budgets in the hospital it is difficult to get our hours
or numbers increased.  As you can see we too fall quite far below the
recommendation and because of this we have had to limit and prioritize who we
see.  We rarely see anyone the first 24 hours after birth (it is the nurses
who get the mothers started and give the initial teaching) and we usually are
seeing the discharging mothers first in the morning before they go home.
After discharges we start seeing the others mothers (greatest need  gets seen
first).  It is much easier the days we are fortunate to have two LC's and
maybe even our secretary working.
 I could say more but this may not be of interest to all if you have further
questions don"t hesitate to email me privately.
Anna Heh IBCLC
Pittsburgh, Pa.

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