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From:
Rachel Myr <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 15 Apr 2003 23:27:34 +0200
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The content of my job has not changed since I became an IBCLC, but I now
belong to a group I can lean on when I need support in that job.  I also
bring more knowledge to the job, because studying for the exam helped me to
focus on what I know and what I need to learn.  Lactnet keeps me on my toes.

This week I had one of those nice phone calls from a mother who really
struggled in the beginning.  We had several contacts during her stay on my
ward, and one outpatient visit a few days after discharge.  I never once got
to witness her baby actually breastfeeding, but I did watch her take him
from violent protests and aversive behavior, to smiling (at the age of 6
days) at the breast.  We talked at length about how to carry on, very
specifically.  By phone she reported he is now, at two weeks, feeding almost
normally, with occasional lapses when she has found silicone nipple shields
to be of help in getting him to latch on.  He is gaining well.  She felt
that the support I gave her was what made the difference between giving up
and continuing on.  I was not the only person supporting her; many of the
staff were involved, and it was such a pleasure seeing the plan we made, get
followed in day to day care.  Her community midwife and the PHN are
following up wonderfully too.  A chink in the bricks, for sure.

Recently a fun thing has been happening when I am consulting with our chief
attending OB about patients who come to the outpatient clinic I work in, for
such things as dressing changes on infected CS wounds.  She starts to write
a prescription, and then says to the woman, 'Let's check with the expert
here - what would you say about breastfeeding with this?' as she turns to
ask ME!  For drugs with equivocal information in our reference book, I can
often help figure out whether it will be a problem or not, and the OB is
open to suggestions for other things.  Another chink - almost a window,
really.

Yesterday I was being accused of being so adamant about not giving formula
that it results in babies going to NICU with hypoglycemia.  'Isn't it better
to just give them a little formula, instead of doing all those blood tests?'
IMO it is better to see whether formula is necessary before giving it, and
for the record I do give it when necessary.  Not everyone ranks these two
possible choices the same way; my ranking is based on a better knowledge of
BF (and of the limits of blood sugar measurements) than that of most of my
colleagues.  But my colleagues may well be more in tune with what parents
see as desirable and undesirable, than I am.  The only thing that makes this
situation bearable is that my boss trusts me, and stands by me.  BTW, in my
entire career, I have transferred less than 5 babies to NICU for
hypoglycemia, and two of these were on the same shift, very recently.  I am
not aware that babies I've cared for, have ended up in NICU after my shift
ended; if they have, no one has informed me of it.  But having a clear
attitude makes you more vulnerable.  I would have been devastated by this
charge (from a midwife colleague who was not involved in the care of either
baby) but for the faith of my boss.  Doesn't take much to feel those bricks!

Whether you become an IBCLC or not, you will meet the brick wall.  Having
the credential gives me the confidence to go at it in my workplace, with a
sledgehammer.
Rachel Myr
Kristiansand

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