The gaping holes in being able to meet the needs are huge,  and
> as you
> said, burn-out is an real challenge. Do those working in  other cities
> experience the same issues?
 
It is the same here in Tel Aviv.  In Israel there are an average of 149,
000 births a year, most in the central highly populated areas.  There
are not enough IBCLC's in the hospitals, resulting in mothers not being
seen in the first 2 days.   There are not enough private IBCLC's to get
out there and help mothers after they have left hospital.  
We have many 5-day wonders,  as Dianne Weissinger used to call them,
out there trying to help moms but not giving good care.
As the profession makes it harder and harder for NN's ( non nurses) to
get enough hours to certify, the number of IBCLC's who have experience
with babies more than 3-4 days old will decrease drastically.  I have
been working in a hospital for so long that I have forgotten how to work
with moms with older babies, as I once did when I started in the
profession.  
I wonder which direction this profession will take. 
>
 
Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel
 

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