Hello, this is my first time to post.  I've been lurking for a while.  My name
is Karen Sieber, RNC, IBCLC.  I work in a hospital that does between 175 to
200 + deliveries a month in Corpus Christi, Texas.  I am the lone lactation
consultant for the hospital.  I would like to provide 7 day coverage but
hospital is unwilling because of money. Since I am the only lactation
consultant employed in the hospital setting except for the neonatal hospital I
guess I'm lucky to be there.  I see breastfeeding mothers, provide education
for employees and patients, do pump rentals and supplies.  Our hospital does
mother/baby care and is the only one in town that does ( out of 4 hospitals
here in town).  The baby is allowed to stay with mother. The transitional care
is done at the bedside and the baby is never taken away from mother unless the
baby needs more care like oxygen, IV etc.  Usually blood sugars are only done
on a case by case basis, mom with gestational diabetes etc. The baby is
allowed to breastfeed right after birth however depending on who the nursery
nurse is, the baby might wait until after the transitional care.  I encourage
my mothers who take breastfeeding class prior to birth to ask to breastfeed
first.  The baby stays with mothers the whole stay except for the pedi exam
the next day ( the initial one is done in the room) and the few things not
done in the room like PKU, Hep B etc.  The mothers can request the baby go to
the nursery at any time.  We do have a policy that states moms must request
supplementation that it is not to be done without dr order or mom request. We
do have problems with this especially at night.  The babies born to moms with
Cesearean do go the transitional nursery for about 2 hours ( dad or support
person can go too). The blood sugars is tested almost always and baby almost
always gets the sugar water. ( this is ongoing battle to get baby to breast
instead of sugar bottle) We have had a level two nursery for babies with IV,
medications etc. and just now opened level three nursery for sicker babies.
Babies in level two either come to moms room or mom goes to the baby. The
level three has a room for the moms to pump or breastfeed baby.
Our hospital has several positives with mother/baby care but we have had some
pedi's not happy with exams in the moms room and have had to provide an exam
room with bright lights.  I and others at hospital were concerned that the
mother/baby care would be changed due to the pedi's complaints so we added a
question to our patient survey. We ask moms how they like the mother/baby
care, if they had had another baby in a traditional setting and how it
compared. Overwhemly, 99 % love mother/baby care and prefer it to the
traditional care. We hope it will help to have the surveys in case the pedi's
do push the change. Well, I know this is long winded and I'm sorry but it is
nice to share information with others in the same situations.  It is very
uplifting to read Lactnet and I have enjoyed the "good" news as there are days
I feel unsuccessful. I hope this post can give info on other ways of doing
things as I know there are many.