Cathy Barger wrote regarding Hospital LCs and how they many times are wearing
a few different hats, or worse yet, floated to different units as a pair of
warm hands. I can't agree with you more!! As a hospital LC, I am part-time M-F
5.5 hrs each day. I must say I am never floated except once to L&D out of
desperation. But the ability to take care of all of the breastfeeding needs of
our patients is sometimes haphazard because of spreading myself too thin.
There is no one to replace me on my off-time (weekends, holiday or vac time).
I've tried to get another part-time LC position added but that costs money ,
you know. We do 1600 del. a year and have a 75% BF population, and a busy
NICU. So much of my own education and prep for giving the nursing staff
training is all done on my own personal time. I am not compensated for that
and need to find a way of documenting this so as to get the administration to
see all that I do on my off time. Did any one out there remember where the
recommendations can be found that state the ratio of LCs to total #of
deliveries/year?

In regards to New York State requiring hospitals to have someone designated in
charge of lactation they don't seem to be stringent at all. Not all hospitals
in our area have someone specifically doing lactation. They may carry the
title on paper but that is all. And when the state surveyed our hospital this
past summer they asked me two very basic questions regarding our program.
1. Do I have people to refer our breastfeeding Moms to after discharge.
2.How is the communication and rapport with the pediatricians regarding
breastfeeding?
I think the more stringent they get in requiring hospitals to staff LCs
without having them wear other hats and requiring a certain ratio of LCs per #
of births per year we might see more support out there.
Hospital administrators just don't get it. Their bottom line is always money.
When patients complain to me about no weekend coverage or me being gone on
vac. I always feel bad. It is a service  at the hospital that shuts down when
I am gone. That just is not right. I have suggested to these patients that
hospitals may listen more to the consumer and that they need to let the
hospital know how valuable the service is and how they should expand the
service.

Jane Ciaramella
From wet and cold NY