I have found that as a Lactation Consultant, I am in a very good position to
teach those who go to deliveries and suction newborns.  In the hospitals
where I have worked it is usually a Nurse Practitioner or Neonatologist if
there is great concern over problems occuring- thick meconium in the
amniotic fluid, prematurity, or suspected problems.
I am current in the NALS, and have to keep current as part of  my job
requirements. I recommend all LCs take the course cause you never know if
you might need it!
I have found that during the NALS instructions, while talking to the
physicians or practitioners and the nursery nurses as well, it is useful to
discuss this issue. The suctioning is necessary in many cases, but many of
them have not thought about their technique, the harm that may be done by
repeated suctioning (more is better to some),
and the consequences to the baby of the oral trauma experienced. Most of
them have been very receptive and interested in adding this to their
knowledge base, and becoming more concerned about the way they handle the
baby. One or two have become defensive and taken the stance, "well the baby
won't be able to breastfeed at all now if it is dead, will it?"  but most
have learned, and I have seen a decrease in the number of babies who are
very orally defensive.  I also find it helpful to explain this to the
parents, not to "make them feel guilty" that something that happened during
their birth may have caused the  problem, but because they will now know
that their baby probably has a very sore throat, and needs a lot of skin to
skin holding and gentle handling in order to heal and be ready.  If the baby
won't latch (or open), I tell them how small amounts of their pumped  milk
is very healing to the sore throat and will begin to make it better.  When I
explain this to them it seems they no longer feel like the baby doesn't like
them or doesn't like breastfeeding, but instead is just not feeling all that
good and will be better soon with the help of the parents.  Parents seem to
relate to this and they seem to begin to hold and bond with the baby more,
and if they need to pump, they seem to want to do it and get those small
amounts of colostrum into baby with a little cup or a few drops at a time
with a small tuberculin syringe so that their milk will begin the healing.
I have had a small amount of opposition from one nurse practitioner who
seemed to want me to be less than honest with parents, but she is gone
now!!!!!
I feel honesty is always best.  I explain what I see, and what may be
causing the problem, and have had wonderful results because of it, parents
who persevere, babies who respond to the gentleness and not being forced or
having their mouths pried open or chins pulled down and the breast stuffed
in.  After all, it is natural to want to open and suck, lest we forget.
Anyone working in a hospital should grab all the teaching moments they can,
and after a period of time, the results will be coming back, and you will be
noticing less and less of these babies who have been traumatized more than
is necessary to clear their airways.

Ann Calandro,RNC,IBCLC
Waxhaw, NC        who had a sore throat and headaches for 3 weeks after
intubation
                               during gall bladder surgery