In response to Lynn Enraght-Moony's request for info.  I am an IBCLC and RNwho
most recently was hired by a small catholic hospital to start a maternal/child
home visit program.  Naturally I insisted on a strong lactation component!
All my nurses have strong backgrounds in BF education as well as the
postpartum/neonatal stuff.  Our visits are "free"--a benefit of delivering at
our hospital and the only requirement is a stay of <36 hours post delivery.
Nearly everyone fits this criteria.  As we just got started in DEC 95, we are
currently seeing first time moms or multips who are breastfeeding for the
first time.  We plan to expand to all vaginal deliveries, then to c-sections.
It's an enormously popular program and we have the expertise to assist those
moms who "fall through the cracks"---(they look good in the hospital-latch,
output etc,
then at the 1-4 week (yes I said 4) things are out of control).  My challenge
at this point is to find out how to convince the managed care companies that
there is financial benefit to them to reimburse for lactation services.  I'm
speaking to the ones in our area on 2 April about what we do in conjunction
with talks by others about our OB svcs.  We have two pediatricians in our area
who have LCs in their offices and they will occasionally make a home visit.
This is billed as a minimal nurse visit, I have the code in my office.  Good
luck to you!  I think home care is the most rewarding work I've done as an
RN!!

Jennifer Hill