Our pissed off list mother has brought up an issue that perhaps those of us
on Lactnet might be able to address. The scenario Kathleen described is one
of the major reasons breastfeeding continuation rates are so low in the US. I
have an idea. In order to make changes at the levels where it is needed we
need data to show that there is a problem. One thing we lack is data on the
number of visits/phone calls made to lactation consultants for the situation
that Kathleen describes, as well as outcomes. Would it be possible for one of
our Lactnet researchers to design a simple form for us to use as a log of
these incidents? Each time a mother contacts one of us, we would fill out the
form and each month send a summary to the hospital or health provider office
that generated the problem.

When we have six months worth or so, we would then send the summary to our
respective state public health department, targeted to the offices that
oversee hospital licensure and Title V funding. Submitting a complaint with
the evidence and continued pressure might help provoke some changes. This
data on "health care utilization" would also be quite valuable in justifying
the need for third party reimbursement for lactation care and services.

I would be happy to have all of the reports sent to me and house them in one
spot. When we get enough we could have them analyzed by an expert to make
recommendations. Sounds like Lactnet could be first author on an article that
might make some change happen. What do people think?

Marsha Walker, RN, IBCLC
Weston, MA

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