At my facility, LC services are marketed as part of the maternity package.
The OB docs want their pts seen, but the one pedi does not. Said pedi
advocates a 4 hr strict feeding schedule, even for jaundiced babies, and
starts cereals at 3 wks, with other foods following at less than 2 mos old.
This doc does not want the LCs telling his pts to feed on demand etc.
Even though the mother cries and asks to see the LC and even if most OBs
write an order for the LC to see her, the LC cannot see the pt. (Chief of OB
bowed to the pedi on this one.)
Directors, DONs, CEOs all agree the physician is in charge. The only thing I
have been able to do to circumvent this is to inform mothers who attend the
prenatal classes that they need to check w/ their pedi as to whether they
will have access to LC services. It is interesting to note that other
pediatricians (in the practice, but junior to this powerful one) want the LC
to see the pts and do not advise the 4 hr schedule etc, but they are not
allowed to write the order. This has been very very frustrating for
directors, nurses, doctors, LCs, and pts, I promise you.
Laurie Wheeler, IBCLC, MN, RN
Methodist Hospital
New Orleans Louisiana, s.e. USA
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