With respect to the discussion on all of the bottles etc. allegedly from the
hospital-based LCs I would like to venture a comment. After 10 years of
private practice I took a position doing hospital rounds 5 months ago.  I
only work 2 - 4 hours per day in a hospital with 250+ births per months and
85 - 90% say they wish to breastfeed.
In private practice I have the luxury of spending a couple of hours with each
mother baby pair compared to attempting to see 10 - 12 moms and babies in a 2
or 3 hour period. Some are doing just fine and require only congratulations
and referrals to community resources for anything that comes up after
discharge.
Often times there are many more forces than the LC in determining if a mother
gives a bottle or cup feeds or uses a lactation aid etc.  If one were to
judge the use of bottles to "solve" problems based on the d/c rate it would
certainly appear that I were very pro-bottle which I am most certainly not!
My input is weighed along with the input from the rest of the nursing staff
and the physician - maybe I get 10 minutes with her and explain how bottles
aren't the best solution for X problem, but then she is later inundated by
conflicting info from other staff trying to help her get her baby fed.
Protecting breastfeeding often falls below feeding the baby - far below.
So, it may not be that the hospital LC is actually recommending excessive use
of bottles (or perhaps it is) but that there are others encouraging the use
of all the bottles.  Just a possibilty.  I used to wonder how come babies
were given so many bottles in the hospital, and now have had the chance to
see how understaffed and overworked many nurses are, plus their breastfeeding
info may be rather limited - even if their intentions are very honorable.

Just my 2 ccs,

Gretchen Andrews, BA, IBCLC
The Lactation Connection
private practice, So. Calif, USA, and daily rounds...

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