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Lactation Information and Discussion <[log in to unmask]>
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From:
Lisa Jones <[log in to unmask]>
Date:
Tue, 17 Jun 2008 15:11:59 -0400
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Lactation Information and Discussion <[log in to unmask]>
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Couple of suggestions.
The AHWONN Clinical competencies are a great tool. The identify clear basic
expectations for all maternal child staff to have for providing
breastfeeding support. It works as an excellent framework to encourage
department managers to support breastfeeding- if your floor nurses can't or
won't provide support at least to  national recognized clinical competency
expectations- what good are they? It takes it out of the "choice" option and
puts it into a basic expected proficiency. Especially if you can get the
managers to include this into the yearly staff evaluations ( translation-
will they get their "raise") 
 As per your class- hearing the desired focus being on use of nipple shields
raises big red flags on the real goal of the staffs expected education
benefits. I agree, your focus should be on a good natural start instead of
dependency on a fast fix.  Someone on list once gave me their policy on
shields. It was the best tool in my kit because the nurses had to :
1) fill out a form  documenting a check list of techniques and options
trialled BEFORE they chose the shield
2) Have mom and nurse sign a "consent" that stated mom had been given all
information on use, care, evaluation of effective shield feedings and
warning signs of
ineffective feeds. 

 This really reduced the lazy fast fix of shield over-use. Once the nurses
realized they could  endanger the infant/mother by misuse/inappropriate use
of the shield ( translation- legally accountable) the number of shield given
out dropped significantly and I heard less complaints from moms that the
nurse just "gave them a shield" instead of providing some real help. Many of
the nurses who gripped about this in the beginning even later started
bragging about how they got a mom through a rough time all on their own.

Good luck
Lisa Jones RN IBCLC

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