I like your post,
Susan. My situation differs almost as much as could be with yours: I live and
work in a suburban-rural setting and visit only by car. Still I carry as little
with me as you and even no scale (I don’t have one and neither do I have pumps
for sale or rent).  I take the forms I may need for this visits, spatulae for
visual inspection of baby’s mouth, a penlight for the same, some 20ml syringes
and CH5 feeding tubes for at breast supplementing or fingerfeeding (which I
rarely use, and in those cases leave with mom as included in the visit fee) and
some fingercondoms (for use if mom wants me to, mostly just thoroughly wash my
hands in mom’s kitchen) and paper mouth/nose masks (only if I have a cold). The
rest of my equipment is stalled in my head ;-)


Warmly,

Gonneke IBCLC, LLLL in southern Netherlands


--- On Sat, 6/28/08, Susan Burger <[log in to unmask]> wrote:
From: Susan Burger <[log in to unmask]>
Subject: Re: [LACTNET] What I carry up and down the subway steps
To: [log in to unmask]
Date: Saturday, June 28, 2008, 1:59 AM

Dear all:

I think I may even carry less than Barbara Wilson Clay.  I carry the weighing
scale and it 
has dawned on me that I use it more as a reinforcement for teaching mothers how
to 
read their infant's feeding cues than any other purpose.  

I may eat my words because we are in an economic downturn that I am beginning
to feel 
--- but because private practice LCs charge a relatively high price in
Manhattan for a 
clientele that is used to "personal trainers" I actually don't
charge --- or only charge cost 
for any supply item that I may feel is necessary for a mother at the time of
the visit.  
Since most of what I use for feeding is inexpensive and I use these items
rarely --- it 
does not eat into my operating costs to an appreciable degree --- probably less
than 1% 
of my monthly phone bill.  I don't carry either the LactAid or the SNS to
sell.   If mothers 
might really benefit from the tube on the breast I simply make the Jack
Newman's tube 
feeding system out of a long feeding tube and whatever bottles the mother might
have on 
hand. It works much better than any other temporary device.  The starter
SNS's tend to 
clog and flow too slowly for most just out of the hospital babies --- I usually
see babies 
on the downswing from when the starter SNS's worked OK because the baby
wasn't yet 
taking much --- but then the feedings get longer and longer as the baby needs
more and 
the tubes on the starter SNS's get clogged.  If they can manage the Jack
Newman's 
system --- then we talk over what permanent system might be appropriate for
them to 
purchase on their own.  Feeding tubes are light weight and when you drag a
scale up and 
down the steps what you carry counts.  

I don't take pillows, pumps or other pump gadgets with me.  They weigh too
much.  I'm 
even cautious on forms.  I carry the forms I need for the visit and just a few
extra of the 
forms that I don't use often.  Paper can add to the weight quickly AND if
you are caught 
in a New York City thunderstorm -- umbrellas quickly blow inside out.  So, even
with 
good plastic protection, papers can still sometimes get wet.  Nothing like
having to throw 
out a big clump of soggy paper because there was one tiny opening in the
plastic 
protector sheets.

Sooooooo... the reality of life in New York if you are middle class forces one
into a 
position of minimizing what you can drag around with you.  Without even working
hard at 
it you end up with a relatively low carbon footprint.  Without having to think
too hard 
about "ethical" issues you often end up not having to worry about
whether or not you will 
be corrupted by selling items.  The mere thought of dragging 15 pounds of pump
along 
with the suitcase that has the scale and forms up and down one to three flights
of stairs 
at every subway stop or up the fifth floor walkups leads to pragmatic
decisions.  

Best, Susan

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