I have been following the threads about night nurses, Chris' most
heartbreaking case, and about MDs not knowing about lactation with great
interest and some frustration - because I am about a week behind in
reading the posts. But I had to reply when Dr. Poinsett wrote her right
on comments about teamwork on 7/20/97.
        None of us trusts someone til they prove themselves. ie you have to
communicate directly with the other person over some time. We judge by
label, until we know who that Doc, Nurse, or LC is and how they act, not
just how they talk. Lots of people talk a good game..who follows
through, who can you trust. Before I was an LC, I was a childbirth
educator and I really learned there not to try to communicate or to
fight my battles through my clients.  Its hard to do it directly,,and
scary at first. But I have never yet had it fail. If you have a
problem..go to the source, and give them a chance to tell you their
perspective..[remember Rashamon].
        I am a hospital based lactation consultant and I have always thought
that the most important part of my job--in the long run would be the
services I provide to staff. I have found something that one of nurse
practioners said to me when I first started very helpful. I had very
little pediatric experience going into this job, and was frankly
intimidated by the NICU. I worried 'how could I be credible in their
eyes' She told me "Marty, you don't have to know that..they already
do..They don't know about breastfeeding, and you do" It has been good
advice..When are we going to accept that people don't know what they
haven't been taught. Docs and nurses don't get any organized 'held
acocountable" training in breastfeeding. If its included its 'elective'-
no one tests them on it.. That's the system we work in folks. I help
educate physicians in my job..Its hard in this system..most are very
interested, but some are too busy or too tired and a few find the
subject uncomfortable or unimportant. I can't control them, only myself
and the information I give them.
        Trying to give people information they don't want to hear is a problem
and I wonder if this isn't part of Chris' dilemma. Those parents are
between a rock and a hard place. I have always belived that our first
duty as LCs, as humans is to help our clients, even more than to help
Breastfeeding. There are times when you have to pull back..and ask
what's the primary problem here, and "what can I do to help' let them
tell you what they want... and don't insist on your way..its not Your
problem [no matter how much you have taken it to heart]
        Last year I started doing something I've found very helpful..for all.
Rather that make rounds to the moms..I make rounds as much as I can to
the nurses. That is I identify who the BF mothers, AND who their nurses
are and go and ask the nurse" How is she doing"   It has many
benefits..I've learned a great deal about who really knows what..and who
really follows through. Best, its allowed me to educate in a targeted
way, and to treat the nurses as individuals.  I would encourage you all
in hospitals to try it. Besides offering them your knowledge and
expertise learn to ask for theirs...run your problems by them. Also if
there are multidisclipinary rounds..join them if you can..you can add
your 2 cents about breastfeeding!

Martha Roseen, BSN, IBCLC