It seems that several hospital based IBCLCs are having their evidence-based
practice restricted. I don't understand how this can be condoned, but it is
at many levels of hosp mgmt.

My situation was that one particular pediatrician recommends strict Q4
hourly feeds x 20 min for all infants, including bf infants, starting solids
at 3 wks of age (cereals and then veggies), will not discharge well babies
with physiologic jaundice whose bilirubin levels are at or near 10 but
initiates phototherapy and continues the restrictive feeding pattern.  This
physician I guess became upset with the  bf teaching 'his mothers' were
receiving, i.e. feed ad lib and in response to early hunger cues. Even
though the OB docs wanted the mothers to continue to receive bf help and
info, and the mothers themselves requested help and support from the LC,
this physician was successful in keeping the LCs from seeing, speaking to by
phone, or having a consult with any of 'his mothers.' This was true even
though many of the mothers had other pediatricians who were not on staff at
the hospital and so were assigned to this pedi for the 1-3 days after the
birth. The physician has added a statement like '"Do not have the lactation
consultant provide bf instruction" to his standing newborn nursery orders.
The LC shared stacks of references, the MD shared none (to my knowledge).
The LC was not allowed to meet w/ said pedi or OB/peds chiefs.
Last month statistics showed that about 20% of bf mothers were not receiving
skilled bf help at this facility, as their infants were under the care of
this physician.  I had never had a pt complaint and had only recieved
stellar evaluations from my manager. I consider my practice to be highly
professional and I have an outstanding reputation. I am sure this is the
case with Winnie and others. This is a slap in the face of all IBCLCs and
mothers who want help and support.

I have slower days now, and get to go to lunch and read my JHL journals. I
clock out earlier and spend more time with my kids. But it still irks me to
no end.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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