>May I ask - what is Tresillian? I have seen it mentioned by Australians
>before on Lactnet and have wondered about it. Is it a hospital, or an
>inststute of some kind? Inquiring minds want to know!
>
>Norma Ritter, IBCLC

I haven't seen anyone else answer this, so I will. ;-) Tresillian is
one of the 'mothercraft homes' that exist in Australia. They are
called different names in the various states but basically do the
same thing.

Their main claim to fame is their 'sleep program' where they teach
mothers to get their babies to sleep 'better', but they also have
staff for helping mothers with breastfeeding problems. The one in
Perth, Western Australia is called Ngala (an aboriginal name I think)
and has some IBCLCs on staff. However, the main qualification of the
staff is child health nurse. These are nurses who have done midwifery
and child health certificates, and are similar to (and exchangeable
with) the nurses who run the well-baby clinics making up the
government-funded child health system. So these mothercraft homes are
an extension of the child health system.

The services provided by Ngala include telephone counselling, booked
visits by a child health nurse, day-stay on the premises, right up to
a residential program, where mother and baby stay overnight. This all
used to be government-funded but increased costs and funding cuts
have meant a reduction in availability of services, especially the
most intensive ones, and there is now a fee for all but the telephone
consults - but I think it is still means-tested so you pay if you can
afford it - and usually a waiting list. I *think* that is how it
works still, but may be a bit behind the times!

As NMAA counsellors, we often hear of mothers who didn't benefit and
hated their stay at Ngala, while Ngala staff will tell you that they
have many happy customers who now get more sleep. Chances are it is
ones who didn't like the parenting style taught there are the ones
more likely to phone the NMAA helpline! For truly desperate families,
whose baby is at risk of physical abuse, etc, I do think these
methods have a place. The thing that bothers me is that they often
advise the 'controlled crying' methods to even people who just phone
for a bit of advice - it is applied too readily and too often, in my
opinion.

They are very pro-breastfeeding and I don't think anyone would be
advised to wean to formula for the mother to get more sleep. Phone
callers are often given the names and numbers of lactation
consultants in private practice.

I do think we are fortunate in Australia to have a government-funded
child health system. Every birth registered results in the mother
linked up to her local child health clinic. The nurse follows up the
mother if she does not contact her for an appointment, so generally
there is good supervision of the baby's early months, regardless of
the family's financial status. The nurses are a valuable resource for
the parents on all aspects of the baby's progress, and she does
various normal developmental checks along the way. If she suspects a
deviation from normal, she refers the mother to an appropriate health
professional. In the case of breastfeeding problems, often this
includes lactation consultants or NMAA, but the nurses vary with how
they view their own expertise in breastfeeding matters and with their
overall support for breastfeeding. Many IBCLCs in Australia are
practising child health nurses and 'their' mothers are fortunate
indeed to get free help when they visit.

Once children start school, they are transferred to the school health
system - similar to the child health system, but covered by a
different set of nurses who are employed in the government schools to
carry out further developmental checks, etc as well as being there to
look after children who get sick or injured at school. Plus the
children go into the school dental program. This is all free. The
school dental coverage continues until the children are about 16
years and covers basic checks, cleaning, fillings, etc, but not more
extensive dental or orthodontic work.

Many babies in Australia never see a paediatrician after the one they
might have seen in the hospital immediately after the birth. The only
time a mother would take her baby to a paediatrician is on the
referral from her GP (family doctor) - you can't just lob up to a
paediatrician, it has to be something that the child health nurse and
GP cannot handle, and you have to have a referral letter from the GP.
So it is only for significant diseases and disorders.

Gee, this got longer than I intended. ;-) Hope it helps to explain
how the Australian system differs from others.

Joy
******************************************************************
Joy Anderson B.Sc. Dip.Ed. Grad.Dip.Med.Tech. IBCLC
Nursing Mothers' Association of Australia breastfeeding counsellor
Perth, Western Australia.   mailto:[log in to unmask]
******************************************************************

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