I was delighted to hear Valerie King ask about a "wish list" from LCs on
assisting in training medical professionals about breastfeeding.  One wish I
have is that there would be initiation of programs promoting grand rounds
with LCs who have clinical, rather than solely academic, experience.   A
strong theoretical background is essential,but I would argue that private
practice LCs see such a range of unusual problems, have to fly by the seat
of their pants so often, and  also are often the first to see a baby with a
problem which is revealed while observing feeds. I think that the breadth of
their hands-on exper with babies of all ages makes them  pragmatic and
creative as teachers and resources.  Panels of this type of LC at conf. or
in med schools just doing Q and A would give residents a chance to dispell
myths and learn really practical information that women would LOVE for their
doctors to know in order to better support bfg.  I love working with
residents, and the type of questions which have been asked when I have
attended workshops for residents indicates that there is a desire to learn
about this, but not much opportunity.

Two other wishes:

 That people would appreciate more fully that positioning is THE MOST
IMPORTANT SKILL.  Many seem to be sick of talking about it, as if it were
some old hat kind of thing that of course they know how to do. (How many
times have YOU heard "Well, they all told me the positioning looked OK"?)
After 17 years of this work I am only now getting good at this skill.  I
consider it the most complex piece of the puzzle, and really understanding
it, and how to manipulate that understanding to solve problems is very
undervalued in the US.  This can be taught, and I wish I'd have had more
opportunity to be taught the skill instead of having to figure it out myself
from reading lactation physiology theory and trying hit or miss with mothers.

That there was more understanding in the US of the mechanisms of milk
over-supply and its consequences.

Barbara Wilson-Clay, BSE, IBCLC
priv. pract. Austin, Tx
Owner LACTNEWS On-Line:  http://moontower.com/bwc/lactnews.html