Jaye said: So the big question for me is - how do we CHANGE this? How do we
change the establishment and help the babies and moms NOT need us?
During the last week I've had the opportunity to speak to 2 groups - one
that included dedicated, passionate health care providers - including
physicians, nurse managers and nurses AND a LOT of IBCLCs - and another my
own breastfeeding task force, which included RDs, Nurses, student nurses and
RDs, La Leche League Leaders, Nurse Practitioners, Public Health Nurses,
health educators of prenatal clinics, and even a (formerly) breastfed boy.
Among us again, there were lots of IBCLCs.
To BOTH groups I gave the same "pep talk":
We will NEVER work ourselves out of work as long as we keep providing
breastfeeding promotion, protection and support. Just like in earlier
times, there will always be some moms who need help from more experienced
moms, and those that need more help from us. I remember my friend telling
me of having to walk to a neighbor's house with a cup to collect some milk
for her baby brother - because her mom, who had breastfed all her other
kids, was having trouble making enough milk for him. Let us not forget that
when EVERYONE breastfeeds - there will STILL be some who need our help.
BUT at the same time, it is MY goal that nurses, RDs and others do the job
THEY need to do - of promoting, protecting and supporting breastfeeding
instead of leaving all of that work to me. In order for me to do the work
that is required of an IBCLC according to IBLCE's description - I cannot
possibly see 20 or 30 moms in a day.
In many hospitals who employ IBCLCs the nursing and dietetic staff are
turning over all the "normal feeding issues" to the IBCLC! THAT'S NO WAY TO
PROMOTE, PROTECT, or SUPPORT BREASTFEEDING - THAT'S A WAY TO BURN OURSELVES
OUT!
We need to make sure that our co-workers are able to provide basic
breastfeeding support and assessment - and refer appropriately, to support
groups, to physicians AND to IBCLCs in a timely manner when there is a need.
(My bosses did this accidentally by hiring me in such a way that I was not
allowed to provide "direct patient care" but rather that I had to provide
"staff education" - so I could only see a mom if I was doing so in order to
teach others how to help a mom breastfeed!)
AND we need to make sure there is a realistic expectation of moms that it's
NORMAL to want and need help - from family, friends, experienced mothers AND
Health Care Providers (including IBCLCs) when necessary. Some of the biggest
problems I've come across have been moms who are emotionally drained due to
the feelings of failure FOR HAVING HAD TO ASK FOR HELP! They are amazed
then I mention the 6 weeks postpartum I went through pretty much calling my
LLLLeaders daily...
So my very long answer to Jaye's question is: NEVER - there will always be
SOME moms that need our (IBCLCs) help - but I also think it is our
responsibility improve the knowledge of as many as we can so that ALL moms
can get correct and timely help from the people they normally interact with
and approach for help.
....now some will say - but "they" don't want to learn... and that may be
true...or is it that we keep trying to approach "them" and teach "them" in
the same manner over and over again - and are surprised that we get the same
result???
....just some late night thinking from a VERY TIRED IBCLC who will be
teaching two back-to-back peer counselor trainings in the next 2 days! One
to WIC staff and one to members of an African American church in a
neighboring town.
Jeanette Panchula
California, USA
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