Dear all: When I worked in International Nutrition I had plenty of opportunity to look at the health care systems within which we were trying to implement effective nutrition programs. So I am constantly thinking about why it is so tough for women in Manhattan. I see huge gaping holes in the care that women receive for breastfeeding Unites States that need to be filled to help women to come closer to the meeting the WHO goals (among the many other societal, cultural and work barriers). I totally agree that we need more breastfeeding medicine specialists. I've been on a run this week sending lots of clients to our beloved breastfeeding medicine specialist, but I'd love to have more in Manhattan to work with. I do not really see any fix for the situation that occurs in the hospitals in Manhattan until such time that our health care system changes in a way that enables staffing nurses to an adequate level and encourages more than drive-by lactation. I KNOW that many of the hospital lactation consultants are highly dedicated and do the best they can within the structure that they have to work. It simply does not permit them sufficient time to give the care that women tell me they want and that I believe they deserve. Then, there are hardly any private practice lactation consultants in Manhattan. There are just a handful that work full time and not as a part time moonlighting endeavor. That to me, is absurd in a city the size of Manhattan. I see many problems in our support groups that would not have occured if these women could have found timely care. Neither I, nor my peers can solve this problem by seeing more clients. We would simply burn out. So, given the time it takes to become an IBCLC, the dearth of women interested in becoming an IBCLC, the limitations on generating enough income as an IBCLC even here in Manhattan, and now a possible reduction in our autonomy, I'm not sure how this gap will ever be filled. Except perhaps developing further the idea of "Breastfeeding Coaches". Best regards, Susan Burger, MHS, PhD, IBCLC *********************************************** 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 email list is powered by LISTSERV (R). There is only one LISTSERV. To learn more, visit: http://www.lsoft.com/LISTSERV-powered.html