Dear Julie, How terrible that a doctor's office laid you off!!!!!!! It seems 
like things are very rough for IBCLCs all over Texas.

I hear that the Private Practice LCs in San Antonio are down to one. I know 
several, including myself, in Houston that have dropped out of PPLC work 
(moms won't pay, doctors won't recommend LCs). The other problem here in 
Houston, is that hospitals have been encouraged to open pump depots and 
outpatient LC programs. This is killing the small pump dealer and those 
trying to do PPLC business. We now have way too many pump stations, but few 
open on weekends and who will carry spare parts.

I also would recommend reading Linda Smith's book. I would also encourage 
you to call all the pump dealers and PPLCs in your area and see if there is 
a need for another business. It could be that there is plenty of need, lots 
of women wanting services or pumps, OR, you might find yourself like those 
of us in Houston and San Antonio with a saturated market and low demand for 
services.

If the PPLCs are doing well in your area, perhaps one of them would have you 
come in to help her out? You might also check with WIC. In Texas, they are 
all supposed to have a contract with an IBCLC, or at least make a good 
attempt to get someone. Again, make sure there is business for you (some 
WICs have the person "on contract" but don't use them -- other agencies use 
them a lot).

Good luck, Kathy Eng, BSW, IBCLC,  SE Houston, TX 

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