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Date: | Sun, 10 Sep 1995 22:10:51 -0400 |
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I appreciated Linda Smith's post elucidating the dif. between adequate
stimulation and adequate milk removal. I'd like to add something about
delayed onset of lactation which may resist pumping interventions. I've seen
3 incidents where women with gestational diabetes had very delayed onset of
lactogenesis. ( Milk came in on days 6-13) The lit. discusses this phenom.
in women with diabetes, but doesn't specif. mention gest. diabetes. I wonder
if this is something Jan B. can tie to her family hist. of late "freshening."
I agree with Jan that we want to be sure to give things time. Baby obviously
must be fed in meantime with most approp. abm.
Also an observation about health insur. I've been trying to figure that one
out for years. My sense now is that we just have to keep hammering away at
this. Bureaucracies always have a kind of inertia and resistance to change.
Why should they begin to do something when they've been getting along
without it all this time? That's the thinking. The pressure that causes
that to change comes from consumers, not service providers. It may also come
from legislative action. They're never going to do it just because its right
or good. I gently remind all the sad/angry/disappointed parents I see that as
soon as they feel better they need to COMPLAIN. Many of the women we see who
are "victims" of the current system are very powerful in their "other lives."
I like to remind them to use that power for change. I'm beginning to see
the fruits of that here in Austin. Companies that independently insure their
employees have begun to repond to employee pressure to add benefits for
lactation services. Some of the HMOs are now considering adding LCs as
covered providers -- mostly because the docs are getting sick of complaints
from moms who didn't feel they got enough help. Once in the system, the
routing and paper work for the referrals and authorizations become automatic
and much less diff. for the insur. companies to accept as part of normal
business. We're new. We can't forget that it took a while for OTs and PTs
RDs etc. to gain acceptance. Keep pushing!
Barbara Wilson-Clay, BSE, IBCLC, Austin, Tx
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