Meg,
Our NICU is licensed for 27 beds; and we are often right around that number for census.  We have one LC dedicated to that area M-F 9-5.  We are consulted on all new admissions for a mother who is planning on breastfeeding.  Daily we round in the NICU and check on pumping journals, evaluate breastshield size for pumping, assist with placing infant in KC and also assist with any latching or breastfeeding issues.  For some of our mother's there is months of pumping before she is able to place that baby to the breast, so we often may feel like cheerleaders, encouraging this mother that she can do it and that the end result (breastfeeding your baby) will so be worth it!  
We do attend weekly rounds with all of our interdisciplinary team members and there we can update the group as to how mother is doing, how infant is breastfeeding etc....  Our NICU is very focused on having our moms breastfeed.  We have one of our doctors who will tell our mothers of our extremely preterm babies that they don't really have a choice... they're going to at least pump milk till their baby gets better.  I have never had a mother argue with a doctor!  Then they realize how much their milk is making a difference for their baby and they're hooked!  We love it!  
If a mother is having issues at any time along her journey while in the  NICU the bedside RN will page the LC.  Once they are discharged from the NICU they can call us in our office or come back for a follow up visit.  We always tell the mother that as long as she is breastfeeding, we're there to support her.

Thanks!
Kelli Fagerness RN IBCLC
Avera McKennan Hospital
Sioux Falls, SD 

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