Susan Hergert asked if I collected data related to initiation rates.  Yes,
to a small extent.  Some people did supply me with that information.
However, in my case I fear using that data because it will work counter to
what I want to accomplish.  I am in an institution without formal Lactation
Services, and I working HARD to get it established.  I do have some
administrative support, but not unconditional support.  Last year we had an
initiation rate here of only 41% (which is up from 35% 2 years ago).  I was
afraid that if I said that the average was 0.7 FTEs per 1000 births and an
average.....say 82% initiation....that my proposal would be shot down.  I
was afraid that my administrators would say, "Well, we have an initiation
rate of half that so we only need 0.35 FTEs."  I only wanted information
that would build my personal battle, not defeat it.  I was not really trying
to speak to the issue of hospital-based LCs as a whole.  I personally
believe, as probably all of you believe, that there isn't enough LCs to do
the real work of supporting women in breastfeeding (one word).  I am and
have for over a year been DESPERATELY trying to gain administrative support
to have a REAL Lactation Service.

Currently there are 4 in my hospital who are Certified Lactation Counselors
(CLC) and the hospital paid us to go to this course.  I am responsible for
staff development (teaching both "old" and newly hired nurses).  The
hospital's childbirth educator was also sent to this course (I have no
financial or personal connection to this course), also with 2 staff nurses.
Currently the 4 of us deal only with problems that arise in a hit or miss
fashion.  I have already written all of the policies and procedures for
Lactation Services, and had them approved by all the pediatrician groups. I
have written a job description.  I have written forms to be used and gained
approval for them through the Medical Records department.  I have done all
the leg work to set up the program, but as of this moment I have not
received administrative approval for the creation of a new position of
Lactation Specialist.  But I am STILL plugging away!

Thanks to all of you who have helped me in my quest for this.

Renece Waller-Wise, RNC, CLC

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