Regarding acuity, I attended a great session by Rebecca Mannel at an ILCA Conference on this topic. Rebecca also was published in the Journal of Human Lactation on the same topic - Defining Lactation Acuity to Improve Patient Safety and Outcomes J Hum Lact May 1, 2011 27: 163- 170. 

I have tried to instate this in the hospital where I work without success. I feel it would greatly cut down on the orders from doctors who haven't even discussed breastfeeding with their patients to see how its going and the ones from the OBs written before mother has put baby to breast. While I can appreciate the apparent support this suggests, in a hospital that had over 11,000 births last year, an average breastfeeding initiation rate in the 80's, and only 5 FT and 2 casual IBCLCs, setting acuity standards would help nurses, many of whom are CBCs, put their skills into practice with initiation and basic teaching/support, which they can and are expected to do, and help them and MDs determine which situations require IBCLC intervention. 

I'd love to see every breastfeeding mother, but with the imbalance of IBCLCs to mothers who are breastfeeding that exists in most hospital settings, acuity standards would help put IBCLCs with the mothers who need them most. 


Cindy Garrison BS IBCLC 
practicing in Pittsburgh, PA 

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