Nikki writes:  "On one hand, I am being paid to help   breastfeeding 
mothers. On the other hand, the hospital and its staff  are  overwhelmingly 
disruptive 
and disrespectful of  breastfeeding."
 
Nikki you have absolutely captured the essence of working as a hospital  based
 LC.  I believe they hire us as a type of window dressing--it's  good PR for 
the hospital--it is not about any deep seated respect or belief in  the 
superiority of breastfeeding or the risk of not doing so. The staff  like us as long 
as nothing is required of them. The only way I can see  this changing is if 
the nursing management holds staff accountable for timely,  accurate 
breastfeeding support and information and also holds them accountable  for poor support 
of breastfeeding. This is not about giving more classes to  the staff. They 
certainly need to be educated but they also need to be REQUIRED  to employ the 
knowledge and skills it takes to get mothers off to the best start  possible.  
They must not be allowed to jeopardize breastfeeding, any more  than they 
would be allowed to jeopardize the health of a pt. with diabetes or  cancer. 
Nurses who don't want to work with breastfeeding should choose a  specialty other 
than maternal-child. Just as nurses are taught to start IV's,  monitor vital 
signs, take care of wounds, give any number of treatments (they  have no choice 
in the matter, they do it or they don't work) they need to be  taught to 
assess and provide the proper assistance with breastfeeding. This  should be the 
biggest part of their job on a maternity unit--not just some  incidental chore 
when and if they feel like it. And pediatricians and OB's  can do much to 
change the culture in hospitals as well. If they talk to their  pts before they 
give birth and write orders which are consistent with support of  breastfeeding 
much of the jeopardization (is that a word?) of breastfeeding  going on in 
hospitals would stop. Formula companies have a huge influence  but we could 
override this if all HCP's truly believed that babies need to  breastfeed and 
developed the skills to help mothers make this happen.   So--off my soap box for 
today, but Nikki I feel your pain.
 
Kathy Boggs, RN, IBCLC 

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