I've always been a bit curious about this.  Our hospital does about 1000
deliveries a year.  Very occasionally (once every few years) a client wants
me to see her in the hospital.  (Usually they don't realize they're in real
trouble until they're home.)

I have always assumed that this is a *private* meeting between a mother -
who is not, after all, hospital property - and me, that she "owns" the
space around her and decides who she wants to let into that space and for
what purpose.  I have never seen that it's a hospital issue at all.  Maybe
that's just been ignorance on my part.

Whenever I see a client, I make up a "cheat sheet" for her, writing down on
triplicate paper the important points that we decide, between us, she needs
to remember.  If I see her at the hospital, I drop off a copy of her "cheat
sheet" at the nurse's station, after explaining who I am and why I was
there.  No one has ever made any comment one way or the other about that
procedure, the nurses who know me like me well enough, and the head nurse
and I have been on congenial "agree to disagree" terms for years.

I think of myself as helping mothers learn to make peanut butter and jelly
sandwiches.  It's not a medical issue unless the mother has *ongoing*
problems getting enough peanut butter on the knife and spreading it evenly,
or the child has *ongoing* problems bringing the sandwich to his mouth or
chewing it or digesting it.  Basically, it's just a life skill that has a
learning curve.  Seen in that light, I think my services fit Jon Ahrensen's
analogy with a minister who needn't add to the hospital chart, and I feel
as if my casual presentation of the "cheat sheet" when I leave is all I
need to do.  If the baby nurses better next time, *that's* what will be
charted.  What do others think?

Maybe I've never had trouble because I never thought to ask permission to
see a mother at her own request.  Along the same lines, I went to see my
hospitalized father (neurosurgical unit) when my son was 6 weeks old.  As I
walked into the hospital carrying the baby, a nurse said, "You can't bring
him in here."  Thinking her concern was for the risk of diseases leaping
onto him as I walked down the hall, never thinking for a moment that I
might be breaking some fundamental hospital policy, I said breezily, "Oh,
he'll be all right.  He's breastfed," and walked on.  Nothing more was
said.  I'm amazed now by my ignorance, my chutzpah, and the fact that my
utter confidence blew away any further objections.  We had a lovely visit
and left, with never another word about the presence of a baby in a
hospital ward...

Diane Wiessinger, MS, IBCLC  Ithaca, NY