I have a situation I would like to share, and I would like to know what I could
do or say to make things better.
A few weeks ago a pediatrician spoke to me rather rudely about the high number
of patients she is seeing that are not nursing by hospital discharge, and said
it was my fault as the LC.  She also said that she would no longer allow me to
cup feed her patients or to use a syringe to feed these nonlatching babies.

I was upset and requested a meeting with her to discuss the situation.  I went
to her optimistic that we could discuss the situation and come up with some type
of solution.  When I got to her office she was very hostile to me.  She said
that  I don't spend enough time making these babies breastfeed.  I explained to
her my gentle waking techniques, that I help mother to get in great position,
help her to hold the breast and do the gentle mouth "tickling", in general set
the stage for all this and then assist in any way I can to get the baby to the
breast.  I told her that if the baby does not latch after about 15 minutes of
working together, I tell the mother we will try again in an hour or so, or if
the baby shows any feeding cues at all, to call me on my pages and I would come
immediately.  If the baby has not latched by 12 hours or so, I usually will have
mom start the pumping process, and then will feed the baby colostrum in a gentle
way.  She asked me why so many babies were having trouble lately.  I told her
that I see a couple a week like this, and in my opinion it is the medications
and birth experience, and that tincture of time and working closely with the
mother would almost always work.

She told me that she wanted me to spend at least an hour at a time with all of
the patients in her practice, even if their babies were latching well and
nursing well, that I needed to watch the whole nursing and not just ten or
fifteen minutes.  I told her that I always did a thorough job of teaching the
mother (I have a whole check list of things I go over) and that I stay as long
as it takes.  She was adamant that I stay with them that long-every time.  I
asked her if she felt that would be empowering to the mother and she said yes,
they all need that.  She says she requires me to have ALL babies sucking and
nursing by 24 hours of age, No moms should go home with a breast pump, and No
alternative feeding methods, even a bottle would be allowed. She said she would
let the mom board if baby is not nursing by then and mom could not go home until
breastfeeding is going well.

Needless to say, I am not happy.  I would love for all babies to latch and nurse
well, I would love to not send moms home with a breast pump.  I would love to
never have to use a syringe or a cup or a nipple shield  BUT
it doesn't seem realistic when 98% of all moms or more have large doses of labor
meds plus an epidural usually.  (In two months I have seen 5 unmedicated moms).
Hospital has 125 births per month.

Any useful articles I could share with this physician?  She is telling me to go
against everything I have learned and know about infants and basically "live"
with this mother and baby until the baby goes to the breast. She is very
supportive of breastfeeding, of course, but I think does not really comprehend
all I have to do each day and all this would involve.  I would appreciate any
input from the 1000 of you.  Thanks..............

Ann Calandro, RNC, IBCLC