Hi everyone,
I am responding to Melissa Kirsch's posting that: "Just having one IBCLC,
especially a part-time one is *not* enough". Depending on the size of the
hospital, it can be enough. It also may be all the hospital is willing to
pay for.
I am the only IBCLC in our hospital. We average about 350-370 births/year,
and have a breastfeeding rate of 70% (an increase from 62% when I started
the program 3 years ago). I work 1 day/week "officially" as the Lactation
nurse, the rest of my time is as L&D, Postpartum, Nursery nurse-depending
on the patient census. I am available at all times for the other nurses to
call me with problems they cannot handle (they are considerate enough to
not call in the middle of the night), or if a mother calls the hospital to
talk specifically with "the lactation nurse".Obviously, I practice my
lactation skills whenever I am at the hospital, and the other nurses (when
I have the help) are great at covering my OB responsibilities if a mother
needs my help with breastfeeding.
I think what makes this work for our department is the commitment of the
majority of our nurses and a very strong nurse manager, who (I am pleased
to say) is now going after her LC certification, so as to replace me when I
move to California. I do a yearly inservice on breastfeeding, with regular
communication to all nurses (and Docs) about the most current approaches to
breastfeeding issues (Thank God for all the help I get from all of you on
Lactnet). All of our nurses should be able to *appropriately* handle any
common breastfeeding issue; we have policies and care plans in place to
help them do so. If they need to get me involved, and leave a message for
me, I usually respond within 8 hours. If they cannot wait for my input,
they do the best they can with the training I've given them (and the
various resources I have available at the hospital). At no time is a mother
ever sent home to fend for herself, without follow-up, when there is a
feeding issue-be it breastfeeding or formula. All of our 1st time
breastfeeding moms, and/or those experiencing difficulties, are contacted
in the first week. ALL breastfeeding mothers are contacted at 2-3 weeks. If
I am on vacation, one of the other nurses makes the calls and arranges for
in hospital follow-up assessments on all first time breastfed babies.
Sorry this got so long, and am really not trying to "toot my own horn"
(though as I read this over it does sound a little self-absorbed--yuk).
Just want you all to know how it can be done. However, just like our new
mom's need a strong support system when they run into difficulties with
breastfeeding, so do we as the lone LC in a hospital. Boy I'm going to miss
this place. Thanks for listening.
Mary A. Banaszewski, RN, IBCLC
Hastings, Minnesota
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