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Subject:
From:
Becky Krumwiede <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 4 Jan 2006 09:11:30 -0600
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Several wonderful people have written me off-list already this morning 
offering to send me policies and protocols, but I apparently was not 
clear in my message last night (too tired, long day).   These are not 
protocols for the nurses that my hospital is wanting--those I have 
written over the years and can come up with fairly easily from all the 
wonderful references out there.  What my manager wants are protocols for 
the lactation consultants--for all the lactation advice we might give 
over the phone or in a consult.  For example, what advice do the 
lactation consultants give a mother with sore nipples?   Well gosh--it 
depends how old her baby is, when it started, what they look like, how 
bad are they--is it likely due to thrush, or poor latch when she got 
engorged, or because the baby has been latching poorly from the start, 
or she has a nipple bleb, or baby is tongue-tied, or !!!?  The advice 
can go sixteen different directions depending on what she tells me!  
That's why I said "my protocols are in my head and in a constant state 
of flux as I read new research and go to conferences" and why I'm having 
trouble wrapping my head around this.  Anybody have anything like this?  
Or maybe just knowing that no other hospital-based lactation consultants 
are required to have something like this might help.  Again, thanks.

Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin

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