Pat,
I truly understand your frustration.  I have seen all to many nurses
who make the same comment.  It seems to be especially true in my
case with NICU nurses.  Usually when I talk to a newly delivered mom
with a baby in NICU that won't be able to nurse for a while, I
concentrate on pumping/expressing, what to expect when milk "comes
in", diet and fluids.  I leave the "mechanics" of breastfeeding
until she will be able to nurse her baby.  However, I don't always
have a chance to talk to her then.  I get called in to "undo" what
SOME OF our NICU nurses have done (some are great).  I'm now
mentioning briefly the approach of the "asymetric" or "lead with the
chin" latch.  Then, maybe, when she can feed baby, a little will
stick in her memory.  At least when I show her how to latch, she may
recognize that she heard that approach before the "shove baby on"
approach she may have been shown by her baby's nurse.

As for changing the nurses.  This is always a big challenge!.  I
think I would approach her with something like, "You know, I used to
take a very different approach to how to get an effective latch than
what I use now.  I have learned a much more effective way to get the
baby to where we want her/him to be.  I have a great short video
that shows this approach.  Would you look at it and let me know what
you think of it."
When we can acknowledge that we may have done things differently in
the past, but are willing to change our approach as we learn more,
staff feels less threatened.  We recently had an intensive 2 hour
(it should have been at least 4) inservice that all staff were
required to attend or watch on video.  One of the things covered was
latching.  Many staff members have changed their technique, but
there will always be a few that went through the motions of  the
inservice and the post-test, but feel that they know more and will
not change. It'
s still worth trying, and trying, and trying.  Remember to also
remind yourself of those who you have been able to influence.  Don't
let yourself think only of the ones who don't change.

Winnie RNC, IBCLC

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