I have been a private practice LC and I have had a personal pump rental
business. I have been, and currently am, a hospital based LC. While it is
true that many moms do not receive the help they need in hospital, and while
it is true most hospitals in my geographic area (and others) are woefully
deficient in breastfeeding support, most LCs are quite capable and caring. I
talk regularly to other hospital based LCs. All of them are quite frustrated
and overworked. For example, at my hospital which does about 100 deliveries
a month, I am the lone LC, in fact you could say that I am the
"breastfeeding program." And I work only 3 days/wk. It is management's
decision not to hire additional staff. At another hospital the LCs there may
have 20 mothers to see in a 6 hr allocation. Their hours and their services
have been curtailed. this caseload would includes several sick/nicu babes to
work with. They are told they must clock out after 6 hrs. They have been
told to discontinue f/u calls and consults. They have to prioritize. Many
LCs at several hospitals REGULARLY clock out but stay hours afterwards to
make sure the moms get the help they need. I take calls at home regularly
and on my off days and weekends, gratis.
When we LCs are together for affiliate mtgs, for example, we are always
talking about our frustrations, about how much we have to do, but there are
so many constraints and barriers. Many of us are quite experienced and
competent. I am not aware of any private practice LCs in New Orleans that I
could refer to. We do have a private practice LC about 100 miles away. I'm
sure lactnetters realize that just because an LC works in a hospital and
only gets to see a mom for a snippet of time, this does not mean that the LC
is not highly qualified.
Re the pump rentals and sales: It is critical to examine the ethics of this
at all times. I appreciate the discussion on this. However if the hospital
has an LC and pumps and gives out other pump competitors ph.nos., it does
seem quite convenient to hire the pump right then and there for a premie,
say, and have the LC come to the room to demonstrate it's use, instruct on
cleaning, storage, labeling, transport, provide written instructions, help
mom pump and then label the milk, etc. I myself have done this at other
hospitals where I worked. I myself have paid a little more, say for a gallon
of milk, instead of driving an extra 10 miles to save a 25 cents. I realize
moms are vulnerable at that time in their lives, but if the price is fair
and the service good, I am not seeing this as an ethics breach. Appreciate
the debate.
Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA
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