Ok, as a hospital based lactation consultant, I have to respond, but I must
confess I haven't been able to keep up on all these posts since the
beginning.  Please keep in mind this is a complicated issue, and the
hospitals are not alone to blame.  I work at a hospital with EXCELLENT
administrative support all the way to the top, and I think we have a top
notch lactation program.  I coordinate an inpatient lactation service and a
home visit program.  We battle with hcp's every day who don't want to clip a
frenulum or prescribe OC's.  However, the difference in this hospital, is
that we have administrative support from the OB Nurse Manager (who is
nursing her 17 month old) to the Director to the Chief Nurse Executive.  How
did that happen?  Lot's of ground work was laid before I came, and
administration was educated.  I think our LC team has been very effective in
helping moms with breastfeeding challenges.  We are currently tracking
breastfeeding duration, and so far the information looks pretty good.  We
provide inpatient and outpatient consults, home visits, a LC phone line,
breastfeeding support group, etc.

My sister recently had a baby in another community, and it was the physician
and his nurse who were giving her bad information.  I won't go into details
here, but if she had followed his advice and hadn't called me, she probably
would not have been successful.  And this advice started in the hospital
directly from the pediatrician.  The LC in this hospital was following in
after him clearing things up.

I think instead of bashing hospitals, we need to support hospital based
lactation consultants, and provide them with the tools to do their jobs.  We
need to look a little deeper as to why we have problems- are the hcp's
writing "unfriendly breastfeeding" orders?  And if they are, they need to
see studies that show their practice is not current.  It concerns me when
hospital based LC's get frustrated and quit- we need good LC's in the
hospitals to move these policies through!

Sorry this is so long, but it's just my $.02!  Thanks for listening, Linda

Linda J. Tandy, MSN, RN, CCM, IBCLC
Clinical Nurse Specialist
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