Daphne,
AWHONN staffing guidelines with recommendations for IBCLC
http://www.awhonn.org/awhonn/content.do?name=04_ConsultingTraining/04_StaffingGuidelines.htm
See FAQ
From ILCA website
http://www.ilca.org/i4a/pages/index.cfm?pageid=3893
Question: What are the staffing guidelines for hospital-based IBCLCs?
Answer: Level of care for patients and level of acuity of the patients are important factors in determining staffing ratios. Will every mother and baby be seen or only those for whom a consultation is requested? Are the mothers/babies referred there for high-risk situations or is it a community hospital? When will lactation services be available - evenings, nights, weekends, holidays? What other units in the hospital will be able to utilize the services - intensive care units, pediatrics, emergency department, clinics? What percentage of mothers need intervention in hospital and post discharge? Answers to these
Questions will help determine the necessary staffing ratio. Resources include:
• Mannel and Mannel, Staffing for Hospital Lactation Programs: Recommendations from a tertiary care teaching hospital, Journal of Human Lactation, 11 2006; vol. 22: pp. 409 - 417.
• Riordan, Breastfeeding and Human Lactation 3rd edition, Jones and Bartlett Publishers; 2004, pp 41: Suggests a minimal staffing ratio of one IBCLC per 1000 births, citing three bedside visits per day per couplet.
• Chapman, Randomized Trial Evaluating a Unique Lactation Consultant Intervention, Journal of Human Lactation, 8 2006; vol. 22: pp. 362-363.
Hope this helps,
Sue
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Daphne Kuehl RN, IBCLC
Sent: Monday, February 13, 2012 5:34 PM
To: [log in to unmask]
Subject: Creating a new hospital-based IBCLC position
Hi all,
Let me introduce myself. I am an RN of 4 years and have worked maternal child health for 2 years. I recently became an IBCLC last October. I took the test in July 2011 when I was 15 days post c-section with my first child. Though my personal breastfeeding story has been rocky (and continues to be so), I am passionate about what I'm doing and to help others with it, too.
I have seen a huge need at the hospital I'm working at to have an IBCLC on staff. Currently, there is none. The breastfeeding culture is poor and there is a huge opportunity to improve. There is a small outpatient support program that is ill-defined where a breastfeeding educator (peer counselor) sees mothers outpatient and gives them electric, hospital-grade pumps. Because there is no one to help moms on a one-on-one basis while moms are in the hospital, the peer counselors have been making "rounds" on inpatients, too. They do not consult with a lactation consultant, including myself, unless I happen to be staffing on the maternal child health unit that day. I am an IBCLC, but I am a staff member without an IBCLC position. I am going to be teaching a breastfeeding basics class to the staff where I am hoping to begin the change in breastfeeding culture that I think needs to happen to help our moms be successful.
I was asked to "convince" the "higher ups" that an IBCLC position is necessary. We are a small rural hospital with about 700 births a year. Does anyone have any comments, thoughts or suggestions as to how to begin this from nothing?
I have considered starting private practice and then possibly "contracting" with the hospital, however the peer counselors are paid by the hospital, and I wonder if it would be a conflict of interest since I am a full-time employee.
Thank you in advance for your responses, Daphne RN, BSN, IBCLC NC, USA
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