Bracha,
I don't know exactly where to begin! I have started 2 lactation programs. 
One in New Orleans which I had to leave aftrer 3 yrs due to Hurricane 
Katrina. Then I came to N.E. Mississippi and started one here in November.
Here are some important things. I think for you especially, coming from LLL 
and private practice, be ready for a culture shock. And, yes, high levels of 
frustration. Mothers will need basic help with positioning and latch. See if 
babies are going to breast soon after birth and try to work on that. Go 
through the educational materials the hospital is using, if any, and replace 
with good info.

A good rapport with the physicians is paramount. A good rapport with your 
immediate supervisor is very important. Try to meet with them if you can, 
and set up some goals first.

Have an idea of how you will deal with the formula salespeople, if they 
market at your hospital.
It goes without saying that you should be highly professional, friendly to 
everyone, as you will likely be highly scrutinized. I hate to sound 
negative, but I am a realist. Document carefully. Let's say a mother is 
supplementing without a medical reason. I would talk to mom and then 
document, "discussed exclusive versus mixed feeding and milk supply; 
encouraged exclusive BF and offered my assistance and follow-up as needed."  
Good luck with this. The moms and babies need you.

Laurie Wheeler, IBCLC, MN, RN
Mississippi, s.e. USA

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