One post was about baby scheduling and subsequent iatrogenic low supply and
peds recommendation of supplementation. I think it was Debbie in Tampa.
Debbie, are you private practice? If so, maybe you could speak to one or two
of the peds about what you are seeing post-discharge. Are there a couple
that you know and are on good terms with? You can share that the moms who
are given ad lib access to their babies and helped with good latch typically
have better outcomes, less wt loss in babies, less jaundice, less
engorgement, etc.

Flat nipples: Very often I see flat nipples in hospital after C-births,
inductions, epidurals (moms getting alot of IV lfuids). Most of them improve
dramatically in a day or two. STS and hand stimulation, hand expression help
alot. Don't bring out a pump too soon (IMHO).

Media: I used to be a bf mediawatcher. I don't know if that program still
exists. I was the coordinator for Louisiana. Any bit of news would be passed
to me, and I would write a response. Quite a few of my letters were
published in journals and newspapers (letters to the editor). To the person
that asked. If you are involved with a coalition or ILCA affiliate, you
could put the word out for everyone to send you any media tidbits. I'm sure
you will get more info about subscribing to some service.

LCs in hospitals: Our hospital and the prior one I worked at found that
mother's were requesting skilled lactation help. Both hospitals asked me to
start a lactation program, which I did. The nurses like that they don't have
to spend loads of time with dyads that are having trouble, (I agree ALL
nurses should be able to give basic bf help and support) including preterm
infants, multiples, and the like. The doctors like that I run a followup
clinic and the babies will be seen about 48 hrs post-discharge, and assessed
for feeding adequacy, weight gain/loss, jaundice, and mother given help and
support for any concerns including engorgement, soreness, etc. I would sell
the LC position with perks such as what I've already mentioned (pt
satisfaction, frees nurses time, followup) and add the LC is a resource
person to staff and doctors, the LC can provide education to staff and pts,
the LC can be a marketing point for the Women's Services.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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