When we first started our program, we had limited hours, so just saw
the problems.  Then as we had a little more time, we at least
dropped in on all nursing moms and left our phone number.  We
finally got some reasonable hours and not only saw every mom, but
also reviewed the breastfeeding teaching with every mom so they
would go away with the same info.  (This is in addition, of course,
to working with any moms having challenges getting nursing off to a
good start.)  We keep working on getting staff to give consistent
info, but it's an ongoing challenge.  Consistency is great for a few
weeks after a big inservice, then the gaps start in again (all new
employees have to view and be tested on the same inservice, so it's
not attrition).  Wish we could put on and require attendance at a
big inservice every year, but that's not feasible with our current
set-up.
We are developing a new approach to breastfeeding teaching which we
hope will bring back some consistency.  The LCs will then be able to
spend more time with concerns and challenges.  I have staunchly held
out, however, for us making at least a brief visit to every nursing
mom.  The brief visit would include several questions:

   How is it going? (let her voice her primary concerns first)
   Do you have any questions or concerns about nursing?
   How does it feel?
   Are you seeing deep jaw excursions?
   How does the nipple look after baby lets go?

Even the most experienced nurses can interpret differently whether a
baby is "nursing well" and one who is doing great one day may have
issues the next.  We would then give her info on our services to
nursing mothers.  When things are going well, such a visit would
take 5 minutes or less.  When a mom calls back with a concern, she
frequently asks by name for the LC that saw her in the hospital.  If
that one isn't there that day, she will, in most cases, be happy to
talk with whoever is there.  To me this means that the personal
touch (rather than just a card in her information packet) makes it
more likely she will reach out if she has concerns.

Winnie

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