I have been reading intently some of the messages regarding the 'new
breed of mothers' and wanted to add my own observations. I work in a small
community hospital (120-130 deliveries per month) and I am the only LC on
staff. Many or our nurses have gone through the Lactation Educator courses
offered locally. As background we strive (not always successfully) to have
babies nurse before going to the nursery, we then encourage STRONGLY that
mothers keep their babies with them, discuss feeding cues, dispel myths about
feeding times although this is sometimes countered by the peds. I  try to see
every first time mother and give her information, give her time to ask
questions. We offer a telephone support line that is covered 7 days a week,
free consultations post discharge, and a twice weekly breastfeeding group
open to all mothers that deliver at the hospital. We have done some
unscientific studies that suggest our breastfeeding  initiation rate is
around 92%. By the way our nurses are not walking billboards for formula, we
have our own lanyards and badge holders with breastfeeding messages that
staff came up with.  We feel as a whole that we are doing as best we can. As
an aside we have also initiated a Breastfeeding task force that meets every
month to try and evaluate how we can improve further. We will have a
pediatrician at our next meeting.

Having said all of this we are a frustrated group. We have many mothers
coming in with very high expectations of their infants, they have a lot of
'book baggage' . We still have many mothers who want to sleep all night and
send the baby to the nursery, (we still have one we are a very old hospital)
some do not want their babies supplemented but do not want to nurse them
either! Some are big readers of Babywise et al. the nurses alert me if they
see any of those books. We still get mothers who want to do both breast and
formula and unfortunately this philosophy is validated by the peds. Many of
our mothers have baby nurses waiting for them back at home which will
completely undo any of the education we have been able to impart. I had a
twin mother today who told me quite frankly that she was not interested in
feeding cues, her boys had to get on a schedule and she had a baby nurse at
home to help her.
I have had three calls this week from mothers who supplemented at night from
5-6 weeks and now they are very angry that their milk supply is going way
down. Now they want me to fix it. Unfortunately these are the mothers who
spread the ongoing fallacy that their milk could not keep up with their
babies and there are a lot of them.

I know this sounds like a long rant but sometimes I do feel like salmon
swimming upstream.

Elaine Robertson IBCLC


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