Hi to all--this is my first "official" communication (altho a note I sent to
KB went "Public" by error) so I'm going to introduce myself: Kathy Rubin, RN,
BSN, CCE, IBCLC '93. I just keep on going back to school for more, so plan to
start in a MSN program this fall (Parent-child with emphasis on BF!). I'm a
member of NJ-LCA; the NJ Taskforce on BF and the Monmouth-Ocean Perinatal
Consortium, as well as my local LLL affiliate, although lately I'm
hard-pressed to attend many meetings. I religiously attend K. Hoover/C.
Mulford's excellent regional conferences in PA (see you in Dec!). I'm looking
forward to attending my first ILCA conference (I ordered my T-shirt) and
meeting many of you there (although I have already met many of you through
LLL-NJ and other conferences that I have attended). Currenty, I work as an LC
in a local level 2 hospital which I job-share with my partner, Joanne. We
make daily rounds on all BF couples; provide inservices (formal and a lot of
1:1) with the nursing staff; teach ante-partum BF classes ; and run a BF
support group bi-monthly that is free to our clients. We have very far to go
in making BF the norm here, but whenever we get discouraged we look at how
far we've come: two years ago, we weren't even in the door; now, we've
revised the info given to BF mothers so nothing is "advertising"; we have the
opportunity to see the moms, often with first feed!; since we've been
there,we've established credibility and rapport so that the staff now calls
us at home or as we walk in the door with "see Mrs. X right away" or "I have
a new delivery who is ready for first feed"!! Of course, the hosp is only
willing to have us there for 2 hrs each day, but this is better than 0,
right? We've even got them to give us a Voicemail # so no more 1AM phone
calls at home!! Our neonatologist is another story--I don't think she
believes Breast is Best, and her protocol (**NO EXCEPTIONS**) is to nipple
feed with h2o, then formula and if baby tolerates this, we can try the breast
(often several days down the road). Once, she caught me cup-feeding one of
her babies who was classically confused and complained to everyone --SCN
staff, supervisors, etc (except ME) about it!! Oh well, who ever said it
wasn't challenging? I am an RN who was educated "in the trenches", but I have
always been in LLL, BF my own three daughters (now 6,10 &13 -very healthy and
intelligent, which I credit to BF at every opportunity!) for a total of 60
months, and have continually attended any conference that comes along (only
if I couldn't teach it better than the presenters!). The most important thing
is that I am continually learning, and know how much I don't know!! Which
brings me to this case:

A mom attended my BF support group last week with her 7 month old, looking
for exactly that -- support. This was my first contact with her, and it seems
that she was told by MD to stop nursing when the baby was 3 mos for a problem
(??), but found out that the baby was violently sensitive (?allergic) to any
type of ABM, and so relactated **on her own**. Only problem is that she has
been unable to get the baby back onto the breast, and so has been pumping 36+
ounces every day and giving it in a bottle!!! The baby is the picture of
health--roly, poly and happy, developing well. I discussed a few options with
her, but wasn't really sure how successful any would be (cup feed,
supplementer, etc) at this baby's age. The mom was most concerned that if
anything happened to her, her baby would not be able to eat, not to mention
that she is tied to the pump every 2 hrs. I commended her for her remarkable
efforts and commitment to this point and also recommended that she see an
allergist to determine whether the baby really had allergic problems, esp
since she is ready for solids. I have invited the mom with her baby to attend
a parenting group that I teach for 6-12 mos olds and she has joined, so I can
stay in contact with her. My partner suggested possibly trying to nurse with
a shield -- my only concern is that even tho the supply is well-established,
this may cause it to diminish. I guess that she could try the shield, and
continue a pumping regime that is certainly no worse than what she is going
thru now; I planned to speak to her about it this week, but discovered
LactNet over the weekend (thanks, ILCA & Globe) so thought I'd throw this out
to those more "expert" than I for any suggestions.
 I'll look forward to your thoughts and, I hope, to a long friendship and
relationship with all of you. My husband, the computer-literate one in the
house, says that this 'net has quickly outgrown its status and that it will
soon have to be changed to another format. (KB & KA, if you need to know more
about this, I'm *not* the one to ask!). Thank you for everything --the forum,
the info, the support and friendships I know will develop...Kathy Rubin,
Freehold NJ (home of Bruce Springsteen).