I will jump into this thread after being away for 3 weeks.
Since January 1998, I am a non-nurse (NN) IBCLC in charge of the Lactation
Program in a large maternity hospital (9000 births per year), which is part
of the largest medical center in Tel Aviv. I not only handled the hands-on
with moms in our dept, but also took all breastfeeding related calls in the
entire hospital as Georgia mentioned in her post. This became overwhelming
at some point since I am only on a half-time position. ( 20 hours/week). IN
order to see as many moms as possible, I do the bf help in a group setting.
I would give a 30 minute bf management talk in my breastfeeding room with
moms and babies all sitting around. I would stop to help a baby latch if
needed in the middle. ( It always amazes me, and I point this out, how
quiet babies are when they are in their moms' arms.)
Later, I started giving the lecture early in the morning without babies so
that dads and grandmothers could join us.
Most of the nursing staff were giving conflicting messages about
breastfeeding and I began begging for a staff training course 3 years ago.
Finally last year we got a budget and gave a basic 30 hour course to all the
nurses. Some got it, others did not and never will. Now I would say that
there is more coverage, but many of the nurses are calling themselves LC's
after the course, and still not giving optimal help. ( Can you imagine what
would happen if I called myself a nurse and gave incorrect advice?) We have
about 6 nurses who will do the exam next year. Oh, and now I have to
prepare them for the exam as another part of my job!!
During this time period, we switched to full rooming-in. This hospital once
had babies on a very strict bf schedule.
The situation to date is that two of the nurses give the lecture in the
morning. All nurses go out to help moms bedside at least once in a shift.
Two are bf-dedicated now, and doing a pretty good job. I am supposedly now
helping those moms with specific problems , although many moms who come to
our hospital ask for my help specifically.
I now see the need to do a training course for the doctors who are now the
ones giving conflicting information, and of course would like to continue
regular yearly up-date courses for the nurses.
There is still a huge problem identifying milk transfer. Many moms tell me
that the "other LC" told her that her baby is breastfeeding beautifully
while I see a baby who is nipple sucking and not getting milk.
I can say that our babies now get fewer bottles of artificial milk as a
solution to breastfeeding problems.
Here in Israel, there is a 95% bf initiation rate, so those first 2 days in
hospital are critical. There is always room for improvement.
Sorry this is so long.
Esther Grunis, IBCLC
Lis Maternity Hospital
Tel Aviv, Israel
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