Hi all
I am not an LC but a breastfeeding counsellor with the Australian
Breastfeeding Association.  I live in a small country, rural town that has a
tourist town some 20 minutes away - the Whitsundays near the Great Barrier
Reef.  There are 14 000 in shire. The local hospital is Baby Friendly and
has round 300 births per year.

Part of the antenatal care includes attendance to 4 antenatal classes that
run for 2 hours each spaced over 4 weeks.  Another counsellor and I share
the antenatal class on Breastfeeding (we do turn about).  We have an hour
session every 5 weeks (there is a week between each "intake") and it is the
last session.  The breastfeeding session is on the same night as the labour
ward tour.   the midwife takes them through the labour ward and the
maternity ward (how many want to miss out on the tour - mother and
partners????) - This means that we have anything from 2 to 12 couples.

Breastfeeding is also integrated into various other topics where normal
behaviours of the new born are explained such as licking, nuzzling,
massaging, sight and hearing, the role of smell, why the baby is not bathed
till 24 hours or so after the birth etc.  Breastfeeding is presented as the
normal continuation and part of the normal on going responses of a baby -
babies are born to breast feed, mothers are encouraged to follow baby's
cues.

We recognise that it is easy to over load participatants with too much info
so our role is

 1. to encourage mothers to look at their breast and practise shaping
(though we know that when mother's follow baby's cues this not often
needed - it is away of encouraging them to get use to handling their
breasts.

 2. to inform them of what red flags they need to be aware of (nappy count,
pain, intuition that there is something wrong)

 3. where to get help

The other issues that we discuss are preparing for life after the birth -
meals, changes in sleep ect. We also encourage the participants to ask lots
of questions - and we get some great ones - at the beginning and after about
20 minutes into the discussion.

By the way - we have a very warm relationship with the local hospital and do
from time to time help with difficulties.


Ruth Fiedler
Australia

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