I have been reaching the posts with great interest.  What a wonderful
discussion forum.  I have just a couple of comments on several posts.

I already sent a post to Lisa with a suggestion concerning herbs.  Besides
the herbalists point of view, I always think it is a good idea to look at
the other side, and there is a biochemist Phd. who has done a lot of work on
the effects of herbs on pregnancy and lactation.  Like drugs, most are fine,
some are not, according to him.  It is often the breakdown products, or
another active ingredient in a compound which cause trouble.  One of our
NICU breastfeeding moms went into a health food store here for some
Fenugreek, which we had suggested.  She came out of the health food store
with six different products they recommended for increasing milk supply.
The woman ended up in the emergency room really sick!  Her doctor was
furious, thinking we had recommended all that stuff.

Mechell,
As an NICU nurse who has attended thousands of high-risk deliveries, I am of
the opinion that one emptying of the stomach does not alter electrolyte
balance significantly.  Don't misunderstand me---I am not saying that I
think all babies' stomachs need to be emptied.  I don't believe that,  and I
am pretty sure (along with this group) that the negative stimulus of a tube
negatively impacts breastfeeding.  However, if you ever pull a lot of blood
and meconium out of a baby's stomach, I hope you don't put it back.  It's
not supposed to be there.

Jane,
I understand your frustration with wearing too many hats and not having
enough support.  I emailed several other listers who have the same problem
with some suggestions if you are interested.  The thing which turned our
lactation program around was patient satisfaction surveys. (three years ago
we had two LC's who covered three hospitals with a total of 24 hours a
week-----HAH! Now we have six LC's and one on-call person doing the same
thing with 80 hours per week)
We got permission to add simple questions to the discharge questionairre,
one of which was "Did you receive CONSISTENT advice on breastfeeding from
all staff members?"   The answer was a resounding "no".  Another was "Do you
feel you got adequate help from the staff to succeed with your desire to
breastfeed?"  Again ----a resounding "no"   As a matter of fact, there were
some pretty scathing comments, along with a few real very complimentary
letters (somebody was doing something right)  Then we did a pretest before a
staff inservice, which everybody did poorly on (simple questions!).  After
that, administration asked us to do a mandatory day-long breastfeeding
conference for every mother-baby, L and D, and NICU nurse in the county.

We also did surveys from our outpatient lactation service, which were
glowing.  We were having to justify our existence.  When anybody was
particularly grateful (and there were lots!) who asked what they could do to
get more help in the hospital, we suggested that woman (and her partner)
write a NICE letter to administration explaining their feelings and
recommending more help in that area.

After one patient threatened to sue the corporation for mismanagement of her
breastfeeding twins in the hospital (she would have won hands-down) my
partner and I defused the whole thing and asked her just to write a letter
to the hospital administration explaining the situation.  She didn't really
want compensation - she wanted change.  The corporation sent her to
California to Chele Marmet to see if she had some suggestions we hadn't
thought of.   It took me sixteen weeks to get one twin latched on after the
debacle in the hospital, and the other never would (even with Chele's help.)
That mom pumped for a year for one baby, and breast fed the other.
That did it.  One successful lawsuit would sure pay for a lot of LC's
salaries.
It took client pressure to achieve it.  Good luck.  Hope it doesn't take
threat of a lawsuit to get plenty of BF help in your area.  Funding suddenly
becomes "available."
Deanne, BSN, IBCLC, LCCE  ("Granny.")

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