In a message dated 10/7/98 10:18:47 PM, Marie D wrote:

<<6.  Is this a common problem-- some sort of a life cycle in breastfeeding
support?>>

Yes I believe so. Maybe a consequence of the sort of - jump in the middle
before starting at the beginning - method/model. Growing pains too.

<< 5.  Where should we concentrate our efforts:........>>

I vote for administration because I've seen how supportive top-notch
administrative Leadership can make things happen. Here are some suggestions
based on my observations and experience: It would be essential for the
administrators to establish a vision and mission for lactation services at
your facility, collaborate to identify a set of goals and objectives for the
program, design strategies to accomplish those goals, get feedback from the
LCs on this plan and foster relationships that will support those efforts.
This is a big job.

The LCs will then be fulfilling admin expectations; clarifying roles, drafting
policy, setting standards and patient care goals, designing procedures,
developing guidelines, staff education and competencies. This is a big job.
The staff will then be working toward meeting their manager's expectations for
breastfeeding patient care and education. The staff will come to realize that
the LCs are there to help them meet those expectations. Symbiotic relationship
established.

Deborah Tobin RN BSN IBCLC LCCE
Northern Virginia USA
In the suburbs outside the Washington DC beltway
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