The LC's where I work see any mom for whom a
consultation is requested.  There are days when almost
every mom I see has a problem solely with positioning
and latch.  Then there are the days when I see the
"train wrecks", dyads for whom seemingly *everything*
is going wrong.

Two things: sometimes the moms I see with positioning
and latch issues have other stuff going on that comes
to light while we talk: medications, chronic illness,
history of bovine lactose intolerance...and I am glad
when I have the chance to educate parents about how
these issues relate to BFing.  A good number of moms I
meet are going back to work and appreciate some
information about introducing the bottle, pumping,
storage, and how to approach their boss (now a bit
easier in California...it's the LAW...heh, heh, heh).


Personally, although I know an LC role entails
assisting with abnormal/unusual/complicated BFing
scenarios, I would miss those "simple" positioning and
latch consults.  They are gratifying, too, like
throwing together a tasty casserole, rather than
cranking out a gourmet meal.  But I enjoy the
challenge of the "train wrecks" as well.  Nothing like
solving a good mystery to keep the grey cells active
and happy!

As to nipple shields, our facility does keep them on
the cart in the supply room... :(   The postpartum
nursing staff is informed that only the LC's should
provide them; I have encountered 2 or 3 moms in the
past year who had gotten them from a (non-LC) nurse.
I am opposed to keeping them on the cart, available to
anyone.  I have made this known at staff meetings, but
I am a relative new-bee on the lactation team, and my
view was sort of pooh-pooh'd.  We don't have a consent
form for their use, but we do have a very good parent
education sheet, with instructions for use and
follow-up care.  EVERY mom I provide with a shield
gets one, and we review the information together,
regardless of how knowledgable or comfortable the
mother is with shield use.  CYA!

Carole Jernigan
RN, IBCLC
Mary Birch Hospital for Women




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