I'd love to participate in a data collection project.  I agree that
convincing the health care policy people of the magnitude of the problem is
a big issue.  One thing we all may be doing too well is sacrificing
ourselves (in terms of time and energy and free services)  thereby masking
to the health care system what the true demand for our services is.

Case in point:  I got a call yesterday from a new father of a two-day old
baby whose wife gave birth in a hospital (the one in Austin) that doesn't
provide any LC services.  The RN told these people to call me -- from the
hospital -- so I could take care of them!!  I don't have hospt. privileges.
They needed immed. help, and since I picked up the phone, I was placed in
the position of having to tell them their problem was not my problem or
trying to help them sight unseen.  Well, for better or worse, I helped them,
but maybe they'd have thrown a great big fit at the hospital if I hadn't
been so forthcoming and accommodating.  And their great big fit might have
had more ultimate advantage than my enabling behavior.

I'm glad that Dori (and I hope other MPHs) chimed in.  We need a carefully
designed form that allows us to capture the relavant data.  Our research
question should be carefully constructed.  What is it we most want to be
able to document:  volume?  types of problems?  cost of delivery of the
service?  The paper that ensues should be co-authored by at least one MD,
PhD, MPH, and IBCLC.  I'd try to shoot for publication in a journal outside
of breastfeeding specifically -- like perhaps one of the health policy
journals or JAMA.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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