Dee Kassing reminds me of why I found it so useful to offer pump trials.
Not only did the mother walk out with the kind of pump that would work best
given her set of circumstances, I got to really learn about how the various
pumps functioned.  This helped me better advise my clients, and to know when
body size and shape made them a better candidate for best results from one
pump vs another.  Because as an IBCLC I have an ethical framework within
which I have agreed to practice, clients got my best clinical judgement, not
my most self-serving economic benefit as the driving principle in terms of
their care.  I like to think this worked pretty well.

The extremely sad part about the way equipment companies marketed and the
way hospitals took over equipment provision is that it was sold as a way to
fund hospt. lactation services.   As if lactation support were not the basic
standard of care after delivering a baby, but was some fluff add-on which
needed to be funded from the gift shop sales.   Would we fund physical
therapy following orthopedic surgery from the sale of crutches???  Often
clerks (rather than LCs) merely sold (rather than counseled) mothers on
equipment use.

In my experience, a half hour of anticipatory guidance provided during a
pump trial with sterilized external parts (pumped milk discarded) resulted
in my own clients going on to have much success and an average of 12 mo. of
pumping during employment.  I've always been proud of that.  When the
retailing of pumps in baby store outlets and hospt. rentals hit our town, my
own practice suffered such economic devastation that I closed my clinic and
returned to a home-based, home visit practice that no longer did anything
with pumps.  The down side of that for women in our city has been that my
considerable expertise in guiding mothers through those choices is no longer
routinely available.  Equally sad is the fact that as the economy worsens,
hospt. based LCs are more and more pulled back into multiple nursing
functions and therefore less available for lactation help.  I always said
that the day would come when the hospts would jetison those services iin a
cost-cutting frenzy, and by then many of  the priv. practice LCs would be
gone due to inability to compete with low-ball pricing and store-front types
of equipment marketing.  The total irony of this is that as the big Ad
Council/Dept. of Women's Health marketing of breastfeeding campaign gears
up, I often wonder do we have the infrastructure to even deal with increased
referrals?

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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