I would like to know about prevailing structures for inpatient hospital LCs. It 
seems that there are many variables. There has been some discussion on 
qualifications here recently. What I'm wondering about is the overlapping 
services of nursing staff, LCs and other HCPs. For BFHI all staff is to be 
trained. If everyone is trained, how are the roles divided up? Who assists 
mothers? Are all breastfeeding assistance requests funneled to LCs? Are LCs 
only for those difficult problems? Is there a middle ground? Who sets up 
pumps? How many families can an LC care for on a post partum ward? in NICU? 
What's involved? A quick question, such as 'how's your breastfeeding today', 
or an in depth exam and consult? Does it depend on the total number of 
clients on a ward? What about communication.. verbal, computer or written 
referrals? What about the day to day BF report on each client? When we add 
in warm lines, equipment care, employee pumping care, inservices, paper work, 
etc., how is everyone fitting this all in a day's work, so all parties feel 
satisfied? In most places around the world, are nurses happy to assist with 
breastfeeding, or happy to hand it off? What is a balance? I'm wondering this 
in relation to the references to staffing ratios. What's realistic? What's 
happening in different areas? I wonder if lack of definition causes friction. Judy

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