OK, Lactnetters.  I feel a little foolish and at the risk of a fairly
decent reputation I'm going to
cry out for HELP!  I've been working in this field for 20 yrs., 10 of
them as an IBCLC.  BUT I've
been working in the community post hospital discharge.  I've just
accepted a position in a local
hospital and I'm finding my knowledge...shall we say...not up to
par!  Is there anywhere to go to
find out what in hospital LC care should "look" like.  While I know
what I would do with a baby
home with mom, I'm not sure that is acceptable in the hospital.  I
guess what I'm seeking is
guidelines for safety?  I like to keep moms and babies together but
is that safe in hospital beds
with a mom that is medicated?  I know I kept my baby in bed with me
but I had no meds.  What
is the standard of practice here?  Has anyone used that "sweet ease"
stuff to entice babies on
to mother's nipples? (the current LC does upon occasion and is that
better than enticing with
formula if NO colostrum is able to be expressed?  What about a mom
with HUGE nipples and a
baby with a small mouth that latches (has had NO bottle or
pacifiers :-) and mom has been warned
of the consequences of using them)and is only getting a mouth full of
nipple but is sucking well
and strong and mom has NO pain in her nipples.  Do we allow this to
continue, making sure she
follows up at local pedi or with hospital LC after discharge to make
sure baby gains or do we complicate
matters and introduce pumping to help maintain supply and then we
have to start with alternate
feeding methods I suppose too.  Mom's hx is 1neonatal death, 1 premie
and this is her first full term
infant and BOTH really want to nurse.

Hmmmmm....nice to have new challenges but I want to HELP not hinder!


Ilene Fabisch, IBCLC, LLLL, WIC BF Co
Listmom wicbfnet and MLCANET
Brockton, MA



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