Hi, I'm Christine Raasch, RN, BSN, IBCLC, CLE  working in a community
hospital with approximately 1000 births per year and new to the LACTNET.
 I've been on the Lactnet about 10 days.   The question about breast
pumps at discharge has prompted me to add my thoughts.
At our hospital we used to give most moms the double pump kit at
discharge.  We discontinued that practice over one year ago because of
cost.  Now it's only given to mothers whose infants aren't nursing and we
can document need for insurers.  It also justifies the cost.
 What we do  is give mothers a sheet of breast pump recommendations that
I compiled because our staff wanted a reference sheet, which is based on
what we have in our pharmacy. I know, conflict of interest, except that I
tell them what other area stores carry them.   We have a case management
program in place so that when I'm not on, the other case managers and the
staff, instruct the mothers on options.  I do tell them to become
comfortable with hand expression since they would find that helpful with
engorgement, should it occur.  But we are a society of "convenience" and
speed and efficiency, so don't hold out much for them in trying to learn
"how to"  when their baby is screaming, their breasts are sore and
possibly leaking and their bottom doesn't feel much better.  This is
where I think I lose moms, so I'll go the route of convenience and hope
they don't go to the cheaper model.

We are also a rental station and have been one for years so that we
didn't have to send a mom to "another place"  at the time of discharge
which helped us provide a continuum of care.  It's working out well and
primarily used by moms who are struggling with breastfeeding.  It doesn't
even begin to cover my salary but the patients appreciate the convenience
and the personal service.

Chris Raasch, RN, IBCLC
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