I keep seeing all the notes and controversy on length of hospital stays and
BF problems from earlier in the week (yes I'm behind on my reading). I agree
that BF problems are not Id'd in the hosp because of short stays but I don't
think longer stays is the answer.  I do think home follow up is probably the
best answer (try and tell that to the insurance CO and get them to pay for
it). I am a maternal child health nurse in home care and I am the one who
gets to go see all those moms 7-10 days after going home.  After they have
already been told to start bottles because they have painful nipples .... I
get to go in and try to 'clean up' the mess. I get so frustrated at having to
deal w nipple confusion, insufficient milk supply, and parents who are so
frustrated by this point that the usually are unwilling to follow through and
give up breastfeeding. If they had follow up w in 24-48 after discharge most
of 'my' moms would probably have little to no problems. If I am able to get
out there during this time frame the problems are usually easy to correct by
changing latches, position and providing basic education.  These moms are
extremely grateful and amazed that a few simple suggestions make such a world
of difference.

Adrienne, (very nervous) IBCLC candidate
Reading, PA

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