In  response to Esther's post, this attitude of the nurses is prevailing and
long standing.   Not a new thing, and I don't believe a result of any
particular thing.  The most common sources of breastfeeding damage are the
hospitals, their policies and the lack of knowledge of their nurses, and
later  the well baby clinic nurses who see the mom's in the first weeks and
months at home.  I have seen more than one failure to thrive baby resulting
from a nurse "supportive of breastfeeding" who didn't look at what the baby
was doing on the breast, but told the mother to "just keep breastfeeding".
I find this is the typical attitude of hospital staff, and has been this way
for years, ever since lactation emerged as a profession.  They do not really
recognize lactation as a science or lactation consulting as a profession.
The attitude is:   " Okay, we admit that there are things about
breastfeeding that we don't know.  However, it is *our*  job, and we don't
need you (LC's) in our domain.  So, come teach us, a lecture or two, a
course or such and such hours, and then we will be able to do our job and we
won't need you (LC's) any more."  The courses given for nurses did attempt
to clarify and stress the point that lactation *is* a science and lactation
consulting *is* a profession, and there is a difference between an IBCLC and
a nurse who sat in a classroom for so and so hours.   However, the nurses
choose to see it the way they believe it is, that it is *their* domain.  It
is sort of like they want to take advantage of us and then dump us.

The ideal situation, as I see it, would be for the nurses to do the job well
to get mothers started in the hospital, and have the really difficult cases
referred to us (and , in the hospital, seen by the hospital LC, which,
ideally, there would be a number of LC's per so many mothers).  But the
nurses don't think they need LC's except to teach them, and then leave
*them*  to be the "LC's".

That is how I see the situation in Israel today.  I don't think anyone
deserves the blame for this. It's an issue of power struggles, human nature,
culture, whatever.  It is not a simple issue, but meanwhile, until it is
ever resolved, if ever, the more knowledge spread around, the better.

>How can you tell the difference between a real LC and an instant one?  A
>real LC, the longer she is in the profession,  learns how much she still
>has to learn, and a rookie LC thinks she knows everything there is to
>know.  Scarey, huh?

As far as this is concerned, I think it's a matter of personality more than
being a rookie or not.  I have been working with breastfeeding mothers (as
an "accredited volunteer counselor") for almost ten years, and I am an IBCLC
as of last summer.  For those years I worked with mothers in the community,
did many home visits, followed up with bf help with mothers who took my
childbirth classes, volunteered in a hospital postpartum ward, interned with
an LC in her private practice, and now in the last year I am developing my
own private practice.
When I got the IBCLC credential, I felt I know less than ever.  Because,
being *certified*, I am supposed to know a lot, yet still I feel I know so
little.    I learn all the time, from the mothers and babies, from
observing, listening, reading, attending conferences when I can, and of
course, from lactnet.   I am humbled by the amount of experience and wisdom
here on lactnet, compared to mine. But I am learning all the time, and, as
Esther said, the more I learn, the more I realize how much more there is to
learn.

Those that think they know all from the beginning will be the ones who
resist change and stifle their own growth and get very stuck in their ways;
and I think this is the case with many nurses who have worked in
L & D or postpartum for ten, twenty, thirty years, and it is the case with
many doctors, too.

Yael Wyshogrod IBCLC
Rechovot, Israel.

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