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 *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome