The content of my job has not changed since I became an IBCLC, but I now belong to a group I can lean on when I need support in that job. I also bring more knowledge to the job, because studying for the exam helped me to focus on what I know and what I need to learn. Lactnet keeps me on my toes. This week I had one of those nice phone calls from a mother who really struggled in the beginning. We had several contacts during her stay on my ward, and one outpatient visit a few days after discharge. I never once got to witness her baby actually breastfeeding, but I did watch her take him from violent protests and aversive behavior, to smiling (at the age of 6 days) at the breast. We talked at length about how to carry on, very specifically. By phone she reported he is now, at two weeks, feeding almost normally, with occasional lapses when she has found silicone nipple shields to be of help in getting him to latch on. He is gaining well. She felt that the support I gave her was what made the difference between giving up and continuing on. I was not the only person supporting her; many of the staff were involved, and it was such a pleasure seeing the plan we made, get followed in day to day care. Her community midwife and the PHN are following up wonderfully too. A chink in the bricks, for sure. Recently a fun thing has been happening when I am consulting with our chief attending OB about patients who come to the outpatient clinic I work in, for such things as dressing changes on infected CS wounds. She starts to write a prescription, and then says to the woman, 'Let's check with the expert here - what would you say about breastfeeding with this?' as she turns to ask ME! For drugs with equivocal information in our reference book, I can often help figure out whether it will be a problem or not, and the OB is open to suggestions for other things. Another chink - almost a window, really. Yesterday I was being accused of being so adamant about not giving formula that it results in babies going to NICU with hypoglycemia. 'Isn't it better to just give them a little formula, instead of doing all those blood tests?' IMO it is better to see whether formula is necessary before giving it, and for the record I do give it when necessary. Not everyone ranks these two possible choices the same way; my ranking is based on a better knowledge of BF (and of the limits of blood sugar measurements) than that of most of my colleagues. But my colleagues may well be more in tune with what parents see as desirable and undesirable, than I am. The only thing that makes this situation bearable is that my boss trusts me, and stands by me. BTW, in my entire career, I have transferred less than 5 babies to NICU for hypoglycemia, and two of these were on the same shift, very recently. I am not aware that babies I've cared for, have ended up in NICU after my shift ended; if they have, no one has informed me of it. But having a clear attitude makes you more vulnerable. I would have been devastated by this charge (from a midwife colleague who was not involved in the care of either baby) but for the faith of my boss. Doesn't take much to feel those bricks! Whether you become an IBCLC or not, you will meet the brick wall. Having the credential gives me the confidence to go at it in my workplace, with a sledgehammer. Rachel Myr Kristiansand *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html