(Lost my first reply post, darn!)

Heather, We all use the products we are comfortable with, but I do not use
cots for several reasons.
1)They are latex, and not only can they cause allergy, but they taste
*awful* and babies tend to gag on the taste. This is the same reason I use
Nitrile gloves and not latex. (I use the purple ones, as I have tiny little
hands.)
2)I am always afraid they will slip off during an asssesment and choke the
baby (this has never happened, but for the short time I used (tried) them,
they got VERY slippery!)
3)They do not give adequeate coverage, fluid can get under them. In the
case of a mom/baby with Hep or CMV ect, I would not feel protected.

(4)My husband laughs at them....wink.)

As for washing, I always wash my hands when entering a client's residence
immediately after saying "Hi." I have been in many homes, and even in the
lowest income enviroments, people have soap and hot water in the bathroom.
I feel this is just about as good as any hospital cleaner. (I have paper
towels for drying in my "bag of tricks, so I am not using clients family
towels.) I also often wash my hands during a consult as much as 3 or more
times. If I have to handle and weigh a naked baby, if I have to examine a
diaper, if I sneeze ect.

I want to be protected, and I certainly want my clients protected, but I
really do learn a lot about my client from skin contact. You (or I) just
can't feel that warmth before and during ejection (or even the overheated
feeling accompanying engorgement or mastitis) with gloves, as well as other
subtle information one gets from skin. Of course in the case of a mother
with a serious illness, this advantage has to be sacrificed.  do have to
rely on my client's self reporting of these conditions, but I have found
most mothers are pretty truthful.

This is a difficult issue. I appreciate all the input.

Mary Jozwiak IBCLC, RLC, LLLL, AAPL
Private Practice

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