Sharon writes:

> <<However, many LCs (and LLLLs) practice outside the hospital setting and
> actually see moms on a very haphazard and sometimes infrequent schedule.
>   Not only does this make mentoring difficult, but it also makes it
> difficult for the LC to keep up her own skill level.  Sometimes many weeks
> go by without seeing anyone.  Although I only work per diem a few times a
> month in the hospital, it does guarantee that I do get at least a minimum
> amount of "hands-on" time with moms and babies.  I have found that the
> upsurge in hospital-based lactation programs with follow-up from the
> in-house LCs has led to a definite decrease in my free-lance LC work, both
> on the telephone and visits.  Admittedly I do not do a lot of solicitation
> for work as I am too busy already, but just word of mouth was enough to
> send me a small but steady number of clients in the past.  Have others
> seen this happening in their areas?>>

I'm a private practice IBCLC in a small rural area.  I used to get calls
every week and I did home visits.  A couple of years ago the only other IBCLC
in my county got a grant to see every mom that delivered at our local
hospital.  Now on the rare occasions that I get a call they say "I can't
reach X.  Can you come?"  When I explain my (very reasonable) charge they say
"I have to PAY you?  X is free!" and they hang up.
I have approached X about working with her, but she has declined.  I guess
she feels neither the grant money nor the small number of mothers who birth
here (about 300/yr) is enough to share.
I do get rare calls from mothers who deliver at another hospital an hour
away, so I see newborns sometimes.  I try to keep up my intellectual skills
by doing a LOT of email helping.  But I miss seeing babies!  It's just not
the same.
Cynthia D. Payne, IBCLC
In the Berkshires of western Massachusetts

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