To All
        I've been afraid to write again since I've been sooo-far behind with
all the wonderful information you folks keep coming out with on Lactnet. I
am now only 6 days behind and am feeling quite proud of myself.
         Things are pretty awful in the Ontario Health care system, what
with hospital closures, downsizings, and lay-offs right now so that all my
energies have been directed in setting up for a Lactation Consultant in our
hospital before we go down to criteria based twenty-four hour discharge for
moms and babys. We are expanding our criteria for discharge a bit more,
thanks to you up in Ottawa.
        Tommorrow I'm being interviewed for the Job of our hospital LC. But
since I have already been doing this on an informal basis it will be really
exiting if I can expand my role to accomadate in patients as well as out
patients and get paid for everything that I do instead of only half. I sure
hope I get the job. The irony now is that although I've finally won a lot of
physicians(including pediatricians) over to the cause of breastfeeding,
because of the LC. position taking up one full-time RN position I seem to
have to re- educate the Nurses re: the importance of a lactation Consultant.
They all feel threatened it seems and have sent the union to try and get rid
of this new (self-made as they describe it) job.I'm also an RN. in this union.
          A big thankyou to all lactation consultants around the world on
Lactnet who keep making me realize that yes! I will continue persuing the
casue of breastfeeding and that my job as an LC. is very necessary. But
since coming onto Lactnet in December, each day you folks teach me how much
I really don't know. How about suggesting to ILCA that we earn some CERPs
for being subscribers or Lactnuts? just a thought.
        Now I have become a bit long winded but it is after midnight. I am
sorry.I do still have to ask my Coumadin question. Today I met with a doctor
who said that his patient would start on Low dose Coumadin for a past
history of  DVT.(deep vein thrombosis). He has checked with the
heomatologist and the peiatrician. Neither feel that it is a problem for the
mom to BF. My understanding has always been Heperin is OK but Coumadin is
not. Has this changed? What should I look for in the infant? The last mother
I had on long term Heperin bled quite lot from the cracked nipples she had
gotten right from start. By the time she was referred to me she was already
very discouraged with the amount of blood the baby was swallowing and
vomiting. Might there be less bleeding with Coumadin?
Sorry for this lengthy letter. I 'll tell you if I succeed in getting the
job. Then I'll describe it to you.

Attie Sandink RN. IBCLC. <[log in to unmask]>