Hello! After 6 months of on and off lurking, I have decided to take the
plunge!  First, an introduction.  My name is Helen Murkowski. (Gary is my
husband, HE named the Emailbox!).  I am an RN with 17 years of OB nursing
experience, L&D, and Mom/Baby. I took the UCLA course in 1993, and became
IBCLC in 1995.  For the past 3 years I have been "growing" a lacatation
support program for the hospital for which I have been employed.  I have 2
sons-Andrew age 12, and David 8.  Both were breastfed, but knowing what I
know now, I would have done some things differently!!  (Starting with having
been more assertive to family and friends who were so unsupportive!)  I have
been following the postings with great interest, and am overwhelmed with the
amount of knowledge and information out there!  I am learning a lot.

I am at this time responding to the discussions on hospital nurses and
policies, as this is an area I have lots of experience in.  I do feel that I
need to speak in defense of many of the great nurses I have worked with over
the years.  It is hard for many to understand how things "work" in a
hospital, and easy to pass judgement.  Don't get me wrong, I am NOT defending
hospital practices, there is a lot I would like to change!  But change takes
time, and I strongly feel that as a hospital based LC, part of my job is to
be that change agent.  When I became an OB nurse in 1980, it was PP/NBN/L&D.
 All babies were kept in the nursery, rooming in was very rare, and all BF
babies NEEDED formula, because after all , mom had no milk yet.  All babies
were taken out every 4 hours, and "fed in" during the night.  Sometimes we
would get those "strange" LLL moms who wanted to nurse all of the time.
 Everyone got A&D for nipples, a bicycle horn pump, and strict instructions
as to feeding times--3 minutes 1st day, 5 min 2nd day and so on.
When I moved to Milwaukee in 1982, I was an L&D nurse, and soon after a new
mom myself.  No one ever taught me-as an RN-anything about breastfeeding.  As
a new mom I was lost--I am thankful to have had 2 very wonderful nurses who
taught me a lot about breastfeeding my very jaundiced, (ABO incompatability),
very banged up 24 hour labor, epidural , midforceps delivery son!! It was not
easy.  I did it "ALL WRONG" according to the teachings of the times!!  I
nursed on demand, every hour sometimes, I slept with my son--dad was working
night shift then, I argued with my mom over giving formula--He IS NOT
STARVING!!  Wow, instincts are powerful when it comes to your own young.  In
the 5 years between kids, I swtitched from L&D nursing, became a MOM/BABY
nurse, and followed my instincts more and more.  When talk of LC's began
surfacing in our community-for hospitals that is-I thought THis is what I
want to do.  So...I lobbied long and hard for time-1st year 2 days a pay
period, 2nd year 4 days etc until it is now my fulltime job.  So to get to my
point---Many OB nurses are "Just following the rules'-I have found that since
I am there, I have made an impact.  I changed the rules! #1 was wrtiting a BF
policy based on the Ten Steps.  Inservices, staff development--I even bought
in food to get people to the inservices.  Changing all teaching materials to
ones we write on our hospital stationary, no formula materials, etc etc.
 Getting MD support, starting with the residients on up to chief of staff,
just saturating the hospital, esp OB,NICU,and PEDS units with breastfeeding
info.  I have found my nursing peers, and many of my medical peers, willing
to listen and learn, as long as I have research based infor. Our M/B staff
are required to meet with me in orientation, as are all of our nursing and
medical students.  (I have better luck with nursing thanwith medical
thoough).  All M/B staff have had breastfeeding competiencies, documented in
their personell files.  1997 is NICU year, I am doing lots of support for
moms  AND nursing staff in the NICU./  I guess my point is to  see HOW
breastfeeding support persons (LC's, LLL, informed nurses and docs, patients
and their advocates, childbirth educators etc) can impact change.  I also
encourage expectant parents to include breastfeeding in their birth plans.
(The staff will say Helen, one of "your moms" is here in labor, she has a
birth plan with breastfeeding)
In 3 years , we have turned our unit around 360 degrees, but their is ALWAYS
room for improvement.  (Next target--pacifiers!) I think it is important to
remember that where ever we practice, we all have the same goal in
mind--healthy breastfeeding moms and babies, and not lose sight of that.  I
feel really SAD when I meet with a mom who feels she must DEFEND herself and
her baby against hospital staff--I offer myself as a buffer and an advocate
for her, and share with her HOW we will support her right to breastfeed her
infant.  I think with increasred consumer awareness, tides will change.
 Hospitals are big business now, and we MUST meet the needs of our consumers.
 LC's are, in my opinion, a part of this.