Had a big conversation with a neonatologist in our hospital who "doesn't
believe in clipping frenulae".  His commentary was that he worked at a
hospital "up north" that saw 3000 pediatric patients per year.  In 20 years
he only saw one freulum clipped.  We do "maybe" 2-3 a week in our hospital.
 This is in a 3500 birth per year hospital with about 67% or more
breastfeeding ratio.  He feels that we are doing too many frenulectomies and
doing them unneccessarily.  What do you guys think about this rate?  He
suggests I call a couple of other local hospitals to look at their rates for
comparison.  The other hospitals have token lactation departments who do not
see all patients or do not EVER make recommendations of this sort.  We
recommend frenulectomies for babies who cannot grasp the breast well or who
badly damage mother's nipples.  I suggested we use Allison Hazelbaker's tool
and he might be open to that.  But I suspect a basic prejudice anti on his
part.

Now for my rant.  I often feel that in our position as lactation consultants
we are given the responsibility of helping the mother/baby from
pre-breastfeeding to established breastfeeding.  The initiation phase is like
a large river that needs to be crossed.  In our practice particularly we are
given minimal staffing to accomplish this feat.  The river is full of
crocodiles and styrofoam stepping stones.  Sometimes the two are
indistinguishable.  You have to move quickly from one stone to another and
hope the crocodiles don't get you in the process!  Ideally, we should be
building a bridge to cross the river.  But if everytime you lay the stonework
for the bridge support, someone knocks out the stones or if you have no time
to work on the bridge because you have to help another mom across the river,
the bridge is delayed.  The concepts of Baby Friendly are the bridge across
the river.  But the people in charge have to see that land across the River
as the Promised Land where every mother should have the right to go!  I could
carry this analagoy further but I won''t.
God Bless all you Breastfeeding Guardian Angels out there, WHATEVER your
degree or qualification!
Jane Kershaw  mailto: [log in to unmask]