Melanie,
FWIW, my experience is that the rates will take care of themselves and
you are less likely to discouraged and burnt out if you take one mother
and baby at a time and do the best you can in the time you have
available. This is especially true in the hospital. Focus on the
breastfeeding moms, and respect the bottlefeeding moms by not actively
trying to "convert" them to breastfeeding unless they show a real desire
for information. Beware that there will be those on the staff just
waiting to hear a complaint from a bottle feeding mom about you. The
largest % of women make up their minds about their feeding method well
ahead of the time you see them.
There are plenty of mothering things you can teach bottle feeding
mothers, such as the benefits of skin to skin, and the importance of
feeding cues, and especially how to pace the bottle feeding so the baby
doesn't struggle to breath, and get overfed. You can even teach them
comfortable ways to deal with engorgement when they get home, with warm
showers and massage, and periodic ice bags if needed, emphasizing that it
is a normal process to be expected.
You can sometimes even say that "some mothers find" that letting the baby
nurse off a little bit now and then actually makes them more comfortable
and gives the baby some benefits, and that they can either slow it down
and stop, or if they find they like it, can change their minds and
continue.
But my sense is that you time will be far more profitably spent with the
moms who have chosen breastfeeding, giving little bits of accurate info
as it's needed, and only at the speed they can assimilate it, which is
often slow, because they are so focused on their babies at that point.
It sounds like the whole "culture" of your hospital and your patient
population is stacked against you, so give valid information to as many
as you can as often as you can, and let the statistics take care of
themselves. Is there any way you can have a "nursing mother's circle" for
45 minutes, 3 days a week or so? Many years ago, that was one way I got
information across to more moms, and was able to use the experience of a
more knowledgeable mom to help, because the other moms are often more
likely to pay attention to someone one of their own race, or culture,
(and in my case, age), etc. This can backfire of course, if you don't
practice in advance how to politely "defuse" old wives tales with "Newer
information is now available that a better way is . . . ."
Good luck, in your job, and with your exam.
Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA
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