I don't know what your practice is like, ours is inner city, medicaid,
working poor.  I get a very limited amount of time to deal with
breastfeeding problems. Like the busy MD, I find I don't have time to help a
breastfeeding mom like she may need to be helped.   I refer liberally to WIC
peer counselors, LLL, hosp LC.  I chiefly serve as the person who lets pg
mom know that breast is best and she can do it, provide basic info, try to
connect her to local LLL group before baby is born,  know to treat mom as
well as baby for thrush (it's summer in Atlantic City :-(   know about meds
(advise hosp staff and other practices on safety of a med for mom.)  I've
also decided to be more vocal about BF issues at ped staff meetings and give
them a good handout every 2 months.

In the average ped practice I think the NP needs to be an NP and the LC
needs to be dedicated to LC.  I can't imagine taking an hour and working
with a mom, knowing there are 14 more patients waiting to see me before
noon!

I guess in the 10 years I've been an NP I have come to understand the docs
who say they are too busy and understand why they grab a bottle.  BUT that
doesn't excuse them, because they can get mom help through the same channels
I do.  They can know the correct basics.  They can recognize the signs that
the dyad needs help.  I guess that is what being an NP/LC does for me.

In my spare time I'm an active LLLLeader and try to help as much as I can at
home in my own town.

Hope this is useful.  Pat in SNJ

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