I have a question for the authorities out there.  Now, mind you, I consider
myself something of an authority on breastfeeding but I am dealing with a
nurse practitioner who doesn't.  She thought the IBCLC initials somehow
included La Leche League and that the exam is administered through them and
apparently she doesn't think highly of this wonderful organization.  When I
*enlightened*  " her she said, "well it's all the same people".  So that
gives you some idea where she stands on breastfeeding.  I have been LLL for
many years.  However, I have added RN, BSN, and IBCLC to those initials and
I believe I have earned the respect that comes with them. 

The problem at hand is, I am an LC in a hospital in a major metropolitan
area. (Yippee!!!.....Hooray!!!.... It's what I've worked for!)  It is a
university hospital and we are affiliated with the major children's hospital
for our state.  I and my position are new to this hospital so I'm not
established here yet.  I was called for a mom at the children's hospital
whom I had spoken to just prior to her child being admitted for dehydration.
I agreed to come see her because I had already had contact with her and they
said their "LC's" were not there that day.  In actuality they don't have any
LC's.  The nurse practitioner I spoke with calls herself that and this place
is notorious for being terrible with breastfeeding mothers.  I have already
told you the NP's opinion of IBCLC's and to make matters worse, her husband
is a neonatologist at this facility and shares her views.  I saw this mom,
baby was >10% wt loss from discharge (though not birth) weight at 3 ½ weeks
when admitted.  Her latch and suck weren't great but not terrible either but
mom didn't seem to have much milk.  I did hear swallows when baby latched so
I know she got something. We did the supplementer and I talked to mom about
galactogogues and a thyroid test.  It was Friday afternoon and I was
thinking of the simplest, most accessible help to get her.   She said her
sister was hypothyroid. Mom had previous hx of successfully breastfeeding 2
previous children though they are teenagers now.  Baby had some minor
problems at birth and remained in hospital for several days after birth.
Problems were minor and resolved by discharge.
   
Baby did great with the supplementer, guzzled it right down at the breast.
I spoke to the mom 2 days after this and she had gotten the galactogogues
and taken them- blessed thistle, fenugreek, brewer's yeast and possibly
mother's milk tea.  I told her to take whichever ones she wanted-and her
milk supply was greatly increased according to her.  She said she was
feeling pretty full and when I saw her previously, her breasts were very
soft and didn't appear full at all even though baby hadn't nursed much since
hospital admit 1 day prior.  Great, I think!  Baby has been discharged-with
the supplementer, per doctor-and I just got a call from the NP and
dietician.  They don't recommend those herbs, they said and they don't want
me recommending them to their patients or to anyone for that matter!  They
want only things that are medically proven and they believed these herbs
have serious side effects.  She specifically mentioned Fenugreek, but she
inferred that all the herbs were potentially harmful. The NP referred to an
article by Ruth Lawrence that came out recently (Jan?) stating that these
herbs shouldn't be used.  This NP has quite a reputation already in this
city :-(, and she is calling herself an LC!  The moms think she is one.  I
need info for this professional that carries some weight.  Anyone know the
article she's talking about?  I have Dr. Lawrence's most recent book (and
that's not what she says in it!) and Riordan/Auerbach as well as  Meds and
Mother's Milk and some others.  Any studies?  This hospital is big on
research so it carries a lot of weight.  I am sending her info I have on the
herbs as well as some on IBCLC's (might as well take the opportunity to
educate!).  She is sending a "letter of concern" to me and my supervisor
(who I think will be supportive) and I want to be prepared for her.  Perhaps
an opportunity for communication.....  

TIA
Marsha Glass RN, BSN, IBCLC and former LLL
Mother of Melissa, Alicia, Aaron, Nathan and Emily

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