Friday, February 20, 2009

Lactation Consultants

I am newly aware of how lousy many Hospital Lactation Consultants are. A friend of mine had a cesarean 2 weeks ago, and baby ended up in the NICU. He also has a breathing condition, where if he gets too excited, he can't breathe well. He is having some trouble with staying calm with breastfeeding, until the milk is letdown.

Apparently the two hospital LCs she dealt with, didn't even give her the most basic of suggestions, such as giving him say half of a bottle of breastmilk, and *then* latching him on when the edge of hunger is gone. Or, stimulating letdown with the first show of interest in nursing from baby, and then latching him on with milk already flowing. Or, using a SNS until he gets the hang of it.

I'm disappointed, and left wondering how many women are receiving less than adequate support, information, or encouragement in breastfeeding...particularly if there are any even slight issues.

How can this be remedied?

Since most women still choose to birth in the hospital, and I'm now seeing that many hospital LCs are not adequately trained, or very knowledgeable ( or perhaps just complacent? )...what are women to do if they themselves don't know where to start? Is this why a good number of women who start out with intentions of breastfeeding, quit? Not enough adequate support?

I'm going to start having La Leche League information on hand, and I may just add "Breastfeeding Help" to my business card.

Why are women left without good support so often anymore? Whether it be regarding natural childbirth, breastfeeding, attachment parenting, non-vaxxing, or non-circing. Why aren't people helping more?


Gombojav Tribe said...

I've met lactation consultants who don't have any children they've breastfed. ???? What's up with that? I usually refer my clients straight to LLL and by-pass the hospital lactation consultant.

Michelle said...

I have the same opinion of hospital LC, LLL helped greatly this last time, number nine, if nothing else for the support and understanding.

Nice blog, glad I found it!

Stacey said...

I've been at the hands of an LC that knows next to nothing, and ended up formula feeding my fisrt baby at 3 weeks. I've also been blessed with meeting a WONDERFUL LC that is very helpful and knowledgeable. Gretchen Andrews, in Riverside, works out of Riverside Community Hospital. There is a breastfeeding clinic every Monday from 9-12 in the Women's Center at the corner of Brockton and 14th St, no appointment neccesary.

trish said...

I think the best thing you can do for a pregnant woman is find out for them, before the birth, who the good IBCLCs are in your area. LLL Leaders usually know the really good ones. And of course, give them contact information for IBCLCs and LLL Leaders to bring with them. I, too, have seen less than good results with women using LCs at hospitals. Very anger provoking!

Anonymous said...

Warning: Way too long - please delete if it's too much band width. : - )
I work with a hospital based lactation department and will sit for the LC exam in July. I gave birth in the 80s - midwife, epidural free, pitocin free, non-induced hospital births. (the good old days, I guess) I've breastfed my four (now adult) children for over a year each. I became a nurse 4.5 years ago and have worked with moms and babies for 3.5 of those years. I've gone to seminars, taken Jan Riordan's class online, read books, looked for information in journal articles, and more. It seems the more I learn, the more I need to learn.

I am saddened to hear of stories of the nightmare LC or the inadequate LC. I've had my "feeling inadequate moments", truth be told. When I enter a room as the "lactation nurse" (since I'm not official yet) I have any number of things to assess - not the least of which is does this mother actually WANT to breastfeed (since it does not always seem so)? Many women birthing in our facility have inductions, epidurals, pitocin, and the whole "package" - and the C-section rate is 30% or more.

When assisting moms and babies on Day one and Day two (or three) over and over again, having things come together easily for a first time breastfeeding mom seems at times to be a rare event. I am always on the lookout for drug-free deliveries to see if that helps. If the first feed goes relatively well (as it often does - but not always) the next 24-48 hours in the hospital environment are filled with interruptions to the process of learning how to breast feed. Most of the moms we see have not attended a class, read a book on breastfeeding, or attended a LLL meeting - so the hill we climb regarding the "norms" is steep. The two questions I get asked over and over again - by both moms and dads: "How do I know the baby is getting anything?" and "How do I know when the baby is done?" They seem to be looking for a schedule from Day one - and some sleep since they're exhausted. With no real idea of what breastfeeding looks like in the first week, they're shell-shocked at times by the reality before them.
Then, there are the logistic issues; babies with small mouths who have moms with large nipples, or sleepy babies who won't latch at the "right time" (hospital environment). There are babies who have had lots of suctioning post-delivery and do not want to have anything else near their mouth, including a breast. There are babies who have a very disorganized suck following a difficult delivery and tongue thrusting does not obtain a latch. There are babies who are near-term who look "term" but who do not get it together in the 48 hours as quickly as the 40 week-ers do.
Lots of factors to consider, in other words, besides the terrible LC who could not get baby latched to mom. This entry is way too long - without even talking about pediatricians and hyperbilirubinemia as complications.

Again - sorry about the long entry. I blog often about my lactation adventures and confusion over "Why Can't Johnnie Suck?" Coincidentally, the two LCs I've learned the most from were "failures" 25 years ago when they had no support. They have a heart for the work they do. Possibly - one of the difficulties with hospital LCs is that they're all dealing with babies in the same timeframe - just post induction, epidural, pitocin, hospital routines, etc. Just a thought.