Marie,
I can really relate to your problem. It is VERY FRUSTRATING to be working in
health care right now. So many are concerned about saving money & cutting
extra programs that don't generate enough revenue. I am suffering a little
burnout these days too. Just when I thought we were becoming more supportive
of breastfeeding, things took a little turn. My perception of the problem is
that we have some new  (& old) nurses on our staff, some of whom have no
mother-baby experience, and don't seem to believe that LC's have the best
advice for the very tired, new mom who is breastfeeding. What can a couple of
bottles hurt? Mom needs to get some sleep so she can cope with this new baby
when she gets home. We also have a problem with nurses wanting babies to eat,
pee & poop within time constraints--these are normal healthy newborns less
than 36 hrs old! Give them a chance to get to the breast before giving a
bottle! Some of our pediatricians are still giving out time worn advice: limit
feedings to 5-10 min., don't nurse more often than every 3-4 hrs, give
supplements until your milk is in, etc. Don't these people care about giving
correct information?

1. I am also an overworked & understaffed staff nurse as well as LC. I often
have to do my consulting in between taking care of my patient load.

2. I think that staff nurses need to know that they do not have to spend a
long period of time with these moms. They need to help them get positioned,
give them appropriate, basic breastfeeding information and then leave them
alone to get started at there own pace. Staff nurses also need to understand
the basics of newborn behavior in the 1st 48 hours of life...many hours of
sleep, irreg. wake & sleep patterns, little hunger, wake patterns similar to
in-utero patterns (they tend to want to be awake more at night),
overstimulation due to hospital procedures & passing baby around to all the
visitors.

3. I think efforts first need to be directed toward administration. You get
the most cooperation from staff when administration shows that breastfeeding
is important. Then when staff start following the policies, the moms start
getting more consistent advice. I made a humorous (or maybe it was more
sarcastic) comment about needing to count all the supplemental bottles given
to babies by the night shift to get them to reduce the amount of
supplementation. It was passed on to someone in administration & we were given
lots of grief about being too pushy about breastfeeding, and something about
moms not needing to feel guilty about giving a bottle.

I could go on & on, but I won't.

Please pass on any advice that you have in handling your situation. I bet
there are lots of us frustrated LC's out there.

Laura Hart, RN, BSN, CCE, IBCLC
Central Florida near Disney World