This is a retransmission that may have been garbled.

As moms and babe are being discharged after 12, 24 and 48 hours
post delivery (I know that this old news for my US colleagues)
we Public Health Nurses are seeing more and more moms and
babes having breastfeeding difficulties, ie cracked, bleeding
and falling nipples, breast engorgement as well as the infant
not attaching correctly at the breast, nipple confusion,
jaundice, discontented, tired, frustrated mom, babe and family.

Our Health Unit is in the process of formulating goals and
objectives, and guidelines for us Public Health Nurses to
follow.  The supervisors verbalize a keen interest in
increasing the breastfeeding rate as well as a desire to help
these early post natal discharges.  Unfortunately their
behaviours do not appear to follow their verbal intent.  As the
only LC in our region I feel that there is a lot of
breastfeeding lip service and that we are going backwards
instead of progressing.  The rural hospitals are supposed to be
supporting breastfeeding but practically every bassinet has a
bottle of abm in it and all have a soother.  All but 1 hospital
have a breastfeeding protocol, (a few years ago they did not
have any).  Only a few health professionals follow the
recommendations.  I realize that the Alberta's Health Care
system is in a period of great change.  As a result the
hospital staffs appear to be getting smaller whereas their case
loads are increasing.  They may be working in ICU one minute
and in the case room the other.  I am not sure if this is
reason to excuse them.  Our Health Unit region include 5 sub
offices and our population is diverse; predominantly rural,
middle class with an important native transient population, an
older population who did not breastfeed and a younger
generation of single mothers.  Would any of you who have a
critical, analytic, rational mind be willing to share insight
and pointers as to set forth goals and objectives, and
guidelines that would reflect an proactive measure in
supporting, promoting and increasing the successful
breastfeeding rate in this community?  Our Health Unit did a
nutrition assessment on children up to one year old 2 years
ago.

I look forward to reading your responses.  Big thanks in
advance.
Rosemarie Allain  RN BScN IBCLC
close to the north pole.
St. Paul, AB, Canada