Good morning.  RE:  time management and prioritizing clients to be seen in
a hospital setting:  When I worked in Wisconsin a couple of years ago, we
had developed criteria for LCs to consult with clients, and I'm including
that list here.

Previous negative breastfeeding experience
Mother requiring time-intensive assistance with breastfeeding
No areolar grasp/audible swallowing by baby for > 24 hours
Mother has flat/inverted nipples
Mother has history of breast surgery
Mother has sore nipples/nipple trauma
Mother has severe, unrelieved engorgement
Multiple births
Infant is becoming dehydrated, developing hyperbilirubinemia or has lost
>7% of birth weight
Infant is premature (<37 weeks gestation)
Infant/maternal separation
Infant has congenital anomaly or neurological impairment which is affecting
ability to breastfeed

Of course, the LCs would also respond to MD/nurse referrals that weren't
included in this list.

Keep in mind, though, that we did >3000 births/year and had LC coverage
(most of the time) from 0700-2300 weekdays and 0700-1700 weekends/holidays.

Wanda Mertick, RN, MN, IBCLC
Port Matilda, PA

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