Jessica wrote:
"breastfeeding is not a measurable, exact science, but in hospital
environments RN's are forced to make it very chartable, scheduled and
measurable......time isn't available to spend 1 hour working with a
breastfeeding mom, so sometimes it is more convenient to intervene with
gadgets and rules when all mom really needs is to learn confidence and
techniques for little stumbling blocks that may present themselves."
I think that this is a fair assessment of the situation.
Mothers who birth their babies in hospitals are subject to hospital norms.
Unfortunately, In the USA the vast majority of hospitals are not Baby
Friendly, and IBCLCs on staff fight an uphill battle. With the best will in
the world, I don't see how I could condense the (average) two hour home
visit I offer in my private practice to the ten minutes available if I was
working in a hospital.
Much of what I do as a private practice IBCLC is related to counseling.
Mothers need to talk about their concerns,and active listening takes time.
It is not something you can hurry along, at least, not unless you are
willing to miss gathering important, relevant information. A mother who is
relaxed and comfortable is more likely to share information, and this does
take time.
Ours is a helping profession. In order to best serve our clients, we need to
staff our hospitals with enough IBCLCs to allow them to do their job. I have
lost count of the number of mothers who have told me that the extent of
their contact with the hospital IBCLC was a head poking around the door
calling out, "Everything going OK? Great!" and then disappearing again. I am
not blaming the staff, only the under-staffing.
Which brings me to the next point.
As Gonneke said, it is time that lactation consultants were recognised as a
separate professsion. Compare our history to that of midwives. Like
midwives, we started out as women helping women, in our case, many times as
volunteers for La Leche League and other,similar organizations. As midwives
became more organized into a recognised profession, they were, almost
everywhere,, also required to be nurses. You had to train as a nurse before
you could do midwife training, and this affected HOW midwives practiced. In
fact, many people now describe certain midwives as MEDwives, because their
practices have become so medically orientated.
We are seeing exactly the same thing happen with lactation consultants. The
new prerequisites for taking the IBCLE exam are pretty much guaranteed to
deter lay, volunteer breastfeeding counselors from becoming IBCLCs. It will
also pretty much ensure that there will be very few IBCLCs working outside
of hospital situations, since the overwhelming majority will also be nurses.
The flip side is that hospitals will not find many reasons to employ non-RN
IBCLCs.
So what will we lose?
- a whole pool of potential candidates who only want to be IBCLCs, not
nurses.
- IBCLCs who see the complete course of lactation, which can last for
years, not just the first few days that mothers spend in maternity units.
I am sure that others will add to that list.
Norma Ritter, IBCLC, RLC
Breastfeeding Matters in the Capital Region
www.NormaRitter.com
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