Dear Susan,

I am seeing this, too.  I think that a lot of the problem is the use of
these seminars to train nurses about breastfeeding and then no follow-up.
We all know that we only retain a small part of what we learn in any one
session.  They bring back the highlights and then when they share with other
nurses, it gets watered down even further until eventually it's just about
getting the baby on the breast by whatever means necessary.  No real
understanding of good latch/positioning - I, too, have had great success
with the Rebecca Glover approach if the baby cannot self-attach well after a
certain period of time.  In hospitals where there are good IBCLC's to
continue the process of education, this kind of stuff doesn't happen so
much.  If the nurses don't continue to update their knowledge, the original
seminar almost ends up being a complete waste of time.  They have to keep up
with other aspects of patient care, but somehow breastfeeding is seen as
static - once you've done the course, you've heard it all.  This is where
local networking can also help so much.  If you can get people together
every so often to exchange ideas, it remains a dynamic process, even if each
individual hospital/clinic doesn't have an IBCLC on staff.

Sharon Knorr, IBCLC, NY

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