Barbara Wilson Clay writes:

They are over-worked, and their case loads are
unreasonably large, preventing them from spending adequate teaching time
with struggling dyads.  This sometimes results in a kind of cheer-leading
for bfg that fails to identify and address red flag issues.  When the
vulnerable dyads go home, often there is no safety net.

Barbara,  in defense of the hospital based lactation center where I work, we
do screen for and recognize red flags, assess breastfeeding effectiveness on
all dyads that come to our attention, begin interventions in the hospital and
provide follow up care. How do we manage this? We run our butts off every day
we work often without breaks and without much thanks except from our very
grateful patients. I guess we should be thankful that our only obligation is
lactation support--we are never pulled back into patient care. We are cheer
leaders for breastfeeding but we are a heck of a lot more than that--we have
no unrealistic ideas that all goes well with just a little "rah rah"about
breastfeeding. Our mothers are medicated to the hilt, babies come out snowed
and we have 48-72 hrs. to get things going. I'm talking 5000 births a yr. and
a 60 bed NICU. I in no way mean to be adversarial but I think we all need to
understand how things are for the other side. I wish all I had to do was be a
cheerleader, but the moms who need just cheerleading never even come to our
attention. We also have a pump rental center--this is in no way to compete
with private LC's but to provide convenience and a readily obtainable pump
for our very stressed NICU moms (from across the state of CA and beyond) and
others who don't have the energy to search around for pumps. Before we rented
pumps, obtaining them was very difficult for our families. We also provide
free pumps to our medically indigent families.

Do most hospitals give just lip service to breastfeeding without providing
adequate resources? Yes. What does the hospital based LC do? She kills
herself to provide the best possible care anyway,  working harder to overcome
the lack of resources.

Kathy Boggs, RN, IBCLC
Mountain View, CA

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