As a hospital based LC I can tell you that we do not always get to do the
kind of job we would like to do.  We have 12 LDR beds, 12 beds on our
original post partum unit, 14 beds on the newer "queen size bed" unit, and 17
beds on the unit that was just given to us from a med-surg floor after we
built on to the hospital.  We have a Level II NICU and a small Peds unit, ER
Peds and Adults pages us from time to time also. We cannot physically see all
of our moms.  We are constantly frustrated that we are seeing pacifiers and
bottles in cribs of BF babies.  Usually we see this as we are flying by a
room or the nursery as we are in a hurry to try to help a Mom who is having
big time problems.  I stopped and made a firm comment to a nurse I saw
dumping formula down a baby under the bili lights.  She glared at me, I said,
did you have the Mom come nurse her baby?  Is she pumping if supplements were
ordered?  I didn't have time to try to "fix" this.  It was already 5:30 and I
am not allowed to work overtime.  I left a note for the LC coming on the next
day to try to look into it.  This nurse has followed us on rounds for 4 hrs,
she has taken our 4 hour basic breastfeeding course.  She does what she has
always done and sees the other nurses still doing.  We do get sporadic
support from our superiors but even they don't 100% understand the entire
breastfeeding process.  They want our patients to rate us "VERY GOOD" on the
surveys.  That is their bottom line.

We had a Dr. and his wife blast Lactation for causing them to feel "guilty"
and fail at breastfeeding with their twins!!  All three days she was with us
we stopped by her room.  Each time Dad was using formula.  We educated
regarding the physiological process of milk production, the whole nine
yards!!  I gave Dad the AAP statement.  We put a pump kit and pump in the
room and Dad told us they would call when she was ready to learn how to pump.
 (She needed to put the babies to her breast!!  But she was in "too much
pain" from her c-section so we offered pumping so that she didn't lose the
ability to make a full supply of milk.  I gave her 6 names and phone numbers
of other moms with twins to call)  On their survey Mom wrote that she would
never use a Lactation Consultant again (she never used as at all) because all
we did was try to make her husband feel like he was sabotaging breastfeeding
and we were not supportive of her pain after her surgery (We have at least a
40% c-section rate and rarely do we have a Mom who is in so much pain she
doesn't want help with breastfeeding.)

My point, we do the best we can.  We walk away many days feeling so
discouraged, but yet we know there were some patients who did benefit from
our services.  We will get phone calls from them, see them in support group,
etc.  Everyone gets our basic information in our breastfeeding booklet, our
phone numbers, LLL phone numbers, etc.  I do NOT stay off the clock and work.
 I do not take phone calls home with me.  Patients need to write on their
surveys if they feel things should have been better as far as Lactation
coverage. There are some patients I have given my beeper number to.  I don't
get them using it much at all.  But if I have a very PP Blues Mom and feel
she needs extra TLC then I want her to know I can be available to her if she
needs me.

We have been told we are a "fluff" service, not vital to the function of the
hospital.  So I am thrilled there are still 4 IBCLCs working there and we try
to do our job the best that we can.

Pam in S. Florida

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