I'm soooo frustrated as a hospital L&D nurse and IBCLC. We have no actual 
position for an IBCLC, but two nurses - myself and another - have become 
IBCLCs and handle what we can in that arena. Because there is no position for 
an IBCLC, we have concentrated much of our efforts on teaching staff to 
handle most problems and refer harder ones to us. The problem we are 
encountering is begin told things like - there is no policy for cup or syringe 
feeding - DO not do it! Pacis are the choice of the mother and recommended 
by AAP, - DO NOT discourage pacifier use. 
Babies with "risk factors" some legit, some not so - like moms under 17 and 
over 35, must be admitted immediately to the nursery for evaluation. Babies 
with sugars under 50 must get immediate nursery admission and 15 ml of ABM -
 per bottle. We have been told these things are not flexible and not open for 
discussion. I feel like we are banging our heads against the wall. 

We did two posters for our unit project - one was copied word for word from 
the AAP statement on the use of human milk, the other from Newman 
recmmendations for skin to skin and early breastfeeding. The project was 
approved in advance, but when the posters went up, they were torn down, 
destoyed and pitched in the trash. I have a suspicion that we'll get counseled 
over them. sigh......

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