Are lactation consultants part of the problem? - Page 2

[justthinkn]

Can I share a great thing the hospital I birthed at did?

Before discharge, any breastfeeding mom is encouraged to set up an appt for an LC visit at 5 days PP. The LC is there is AWESOME, and the appt. is actually a group of just delivered moms and newborns who all sit in a circle getting help from the LC, working out latch issues, talking out problems, etc., so you all get to listen in on the advice the other moms are getting, as well as potentially chat a bit yourselves. You can even ask the LC about other non-nursing concerns, since she's also an RN. Follow-ups appts are scheduled as needed, arrangements for hospital quality pumps to be delivered are made as need... Then she gives a quick 10-15m talk on breastfeeding, why it's so important, what to expect (cluster feeding, etc.). Invitations are given to come to her monthly nursing support group. All the moms are given a "prescription" to take home that basically says, don't do much the next few weeks - rest and nurse your baby - great to show anyone who's expecting you to do too much!

Oh, and b/c all LC appts are made in this group fashion, it's technically a "health class" and that makes it free! Since I ended up going once a week for 3 months, wow, was that a benefit!!

[gabeycakesmama]

The hospital that I delivered at does something similar. They have a drop in every single week day for an hour. It's free. Anyone can attend, even if you didn't deliver at said hospital. It's staffed by at least one ICBLC, most times there's two.

It has hands-down been the most amazing resource, especially in the very early days when I felt like giving up. They helped us through jaundice and kept us from supplementing when the ped made me feel inadequate. Some weeks I was there every single day. I still go once a week. The drop-in group kept me going!

I love our lactation consultants :

[bobandjess99]

I think many Lc's, even IBCLC,'s, do "water down" or just get discouraged, or whatever....I know some hospital based ones here, and they have very different personalities....at least one is *VERY* concerned about not pressuring moms, or making them "feel guilty" and as such, she ends up essentially just placating moms who choose not to BF...which is not at all the role of an LC, in my opinion....

[polykow]

Originally Posted by Kappa

S

So, would it have helped if you had an LC call you around the 2 weeks mark and say:
1) Has cluster feeding started?
2) If not, it will start w/i a few days.
3) It will seem as if the baby is constantly hungry and s/he will need to nurse more often than every X hours.
4) Do not worry, this is normal.
5) It accomodates the baby's growth spurt, and increases your supply so that you may be able to meet your baby's needs in the next few weeks.
6) If you have X wet diapers and regular BMs, then you have enough milk.
7) Do not supplement.
8) Call me if you have any more questions.

I think this could help most people

I used to work in a local hospital birth center as a CLC and with two more girls that where IBCLC
and I used to do all those phone calls and let me tell you it works only in a very small percentage of moms. Moms that really want to breastfeed.
If they are looking for an excuse or have no support from family and friends it is almost impossible because people keep making them feel like failures.
There are some bad LCs ( few) and some good ones. But its very frustrating
to work and see moms give up for very little.
But t is also very upseting to talk to moms who ended up not breastfeeding because of just plain bad info from doctors, books, and friends.

[klocke]

I didn't read all the posts so forgive me if this has already been mentioned.
LC that work for hospitals can be put in a difficult position. I know at my local hospital the LCs are required to sale so many breastfeeding related products a month to new moms. They will actually come to a first consultant trying to sell a expensive breast pump that the mom will probably never need. This can definitely interfer with the act of teaching a mom how to nurse. I also agree that there isn't enough education out there that says "breastfeeding doesn't always come naturally or easily".

[smanore]

Originally Posted by klocke

LC that work for hospitals can be put in a difficult position. I know at my local hospital the LCs are required to sale so many breastfeeding related products a month to new moms. They will actually come to a first consultant trying to sell a expensive breast pump that the mom will probably never need.

Perhaps the hospital this LC works at, makes this a requirement to help pay the LCs salaries, (I'm totally throwing out a guess here), but it is unethical for LCs to sell products to moms just to meet a quota etc. I've never heard of such a thing. I wonder what ILCA would say about it.

[JamieCatheryn]

The LC at my pediatrician's office demanded we supplement my jaundiced newborn babe. My nipples wouldn't draw out well and he was too sleepy to latch well and nurse, he lost over 10% of his weight, so if we didn't get formula into him she and the doctor said he would be taken away and hospitalized. No suggestion of nipple shields or expressing, which are the solutions DH and I decided on ourselves to get colostrum and breastmilk into him when nursing wasn't working. In a return visit for weighing we told her the formula wouldn't stay down (we tried, he puked every drop up) and I was expressing. His weight had stabilized and started to gain back. She was impressed and completely surprised that I'd done this. So no help from this LC, just threats and formula pushing.

[buttercupmama]

My lactation story is a very long one. I'll summarize by saying that every LC and LN I saw at the hospital where I gave birth was useless. Worse than useless. They were completely counterproductive. I wanted very much to breastfeed exclusively and they almost destroyed that. If I hadn't taken matters into my own hands and taught myself everything I needed to know, my baby would have ended up on formula.

They come in wielding nipple shields before they even know if there's a problem. They slap them on you so fast, you don't have time to make sense of what's going on. They give you lots of misinformation. In fact, everything they told me was wrong. They are so extremely negative, I can't imagine anyone wanting to breastfeed not leaving completely confused and depressed by them. I'm amazed if anyone even leaves that hospital wanting to breastfeed.

I concluded through things said in the visit with the head LN there that she either didn't have kids or didn't breastfeed them. I think experience makes a world of difference. The only helpful person in that hospital was a RN who was available only for one of our feedings. I wish she had spent more time with us. She had experience and briefly shared it with me.

[meganmarie]

One thing I worry about with this new baby is that I have to go back to work at 6 weeks. That coincides with a growth spurt. I'm going to try to induce oversupply before returning to work, though...

Kind of off topic I guess but just wanted to respond to this. The nice thing about inducing oversupply as you probably know is that it kills two birds with one stone. If you start pumping now after nursing sessions (especially in the early morning when there's generally more supply anyway) that will get the body primed for when you return to work...AND if you freeze that extra milk, you'll have a stash ready if baby has a jump in demand before you can catch up. When I was working and pumping, a good solid freezer stash was critical - I worked really hard to build it up and keep it - because it sometimes happened that I would have a "bad" pumping day, or baby would have an extra-hungry-day, and if I was just pumping from one day to the next I would have been in trouble. I pumped at work until each of my babies was over 1 year and there was only one single time of all that where I got stuck and DH had to give a little formula - when I had to take an unexpected overnight trip and my freezer stash had run too low. It still makes me : but I guess I shouldn't take it too hard.

[julie128]

I think that a big part of the problem for hospital lc's is time. They don't have enough time to spend with each client, so they take short cuts, such as nipple shields. I had crappy lc's in the hospital. The first spent less than five minutes with me, and the second spent less than one minute with me. Truly abismal. I just powered through. A lot of it, though, is the mothers (and unsupportive or ignorant dads and g'mas, etc.) who just don't want to put in the work for the short term in order to get a long term benefit. It's the story of modern America, basically.

[elizaMM]

op here.

I really feel like I understand a lot more now. Thanks to all for sharing your insight and stories. I definitely appreciate lactation consultants and all that they DO. But having only used the services of one fantastic one, my understanding was limited.

There are many convolutedly shaped pieces of this puzzle. With this one substantially understood, I can proceed with still more confidence in my personal lactivist revolution.

[Macnamara]

Originally Posted by buttercupmama

My lactation story is a very long one. I'll summarize by saying that every LC and LN I saw at the hospital where I gave birth was useless. Worse than useless. They were completely counterproductive. I wanted very much to breastfeed exclusively and they almost destroyed that. If I hadn't taken matters into my own hands and taught myself everything I needed to know, my baby would have ended up on formula.

They come in wielding nipple shields before they even know if there's a problem. They slap them on you so fast, you don't have time to make sense of what's going on. They give you lots of misinformation. In fact, everything they told me was wrong. They are so extremely negative, I can't imagine anyone wanting to breastfeed not leaving completely confused and depressed by them. I'm amazed if anyone even leaves that hospital wanting to breastfeed.

I concluded through things said in the visit with the head LN there that she either didn't have kids or didn't breastfeed them. I think experience makes a world of difference. The only helpful person in that hospital was a RN who was available only for one of our feedings. I wish she had spent more time with us. She had experience and briefly shared it with me.

Geesh. That sounds like my experience. The only helpful person I had was a pregnant nurse from the nursery. She spent alot of time with me making everything was going ok.

I had a question about latch and just wondered if I was doing everything ok. The LC popped in and said, "looks good" and out the door she went. She really didn't even look at me or the baby to see what the latch was like.

[Ophelia]

I did not get a LC in the hospital after birth

And we asked for one at least twice. I think she was busy with others and never showed up. Some nurses tried to help me. DS's latch was extremely painful and continued to be for 3-4 months. I didn't find out until a home visit about 5 days after birth that DS had tongue tie, which really should have been caught right away in the hospital. In fact the nurse at the home visit said she was surprised no one mentioned it because it was obvious.

So, I think the problem there was not enough LC's to go around.

[Romana]

Originally Posted by 2lilsweetfoxes

One thing I worry about with this new baby is that I have to go back to work at 6 weeks. That coincides with a growth spurt. I'm going to try to induce oversupply before returning to work, though...

Build a good stash before you go back to work by pumping first thing in the morning after the baby's first feeding. I did this with #2 . . . started with only an ounce or two but within two weeks I was getting an extra 8-10 ounces every morning. I kept up that extra pumping session for as long as I could (I think until the baby was about 4-5 months old), and it really helped me build a big freezer stash and not have to worry about how much I was pumping.

I went back to work at 8 wks pp. My baby is still getting probably 80-90% of his calories from breastmilk at almost 11 months old.

[Storm Bride]

I'm not responding to the actual comments in the OP, but I will say that I won't allow a lactation consultant to come anywhere near me after the way I was treated when ds2 was born. I really wish I'd filed assault charges.

She wasn't handing out formula and such - in fact, I'd say she was very zealous about breastfeeding. She was also extremely disrespectful and I have to wonder how many breastfeeding relationships she's sabotaged...

When I hear "lactation consultant", I flinch.

[mamatoady]

Whe I was in the hospital with my daughter, she was so drugged that she'd nurse for a minute (literally) and fall asleep, sometimes impossible to wake up. The lactation consultant didn't help that much--she didn't need to because dd wasn't ever awake for her to see what was happening. Then when I got home, I realized I could not get her to latch on and it was hell. Our hospital has weekly breastfeeding meetings and anywhere from 3 to 15 moms show up weekly with nursing babies/toddlers I've seen as old as 2-3.

It was the same nurses there as at the hospital and they were wonderful--they just needed more of a chance to help me. I've found that some were more knowledgeable than others, all would look for resources when they didn't know something (as opposed to pulling answers out their butt or saying I don't know)....Most were very naturally minded. One spoke freely of nursing her dd until she was 5 and one spoke freely of her homebirth and nursing her sisters baby when her sister had problems and couldn't nurse.

I think in most situations, it's individual and not the training they receive. I did have one lactation consultant that told me I had and inverted nipple and needed a shield, but she was wrong and I knew it and never used it. She was not one of the nurses from the hospital though, she was an independent.

sarah

[francie024]

Nurses are the REAL culprit

I think that some nurses give the babies formula back in the nursery and then do not tell the lactation consultant. Baby is already full and when put to the breast, SCREAMS because they just want to sleep and don't want anything shoved in their mouth. Then the mother thinks there is a "problem with her milk." and calls a lactation consult when she should be screaming at the nurse for giving the baby formula.

Also, why are women expecting their milk to come it at the hospital????? My milk took 5 days to come in. And until then, colostrum was enough. And what is it with feeding schedules??? Some babies might want to nurse every few minutes? That is natural and does not mean a woman is not producing enough.

In my opinion, the whole HOSPITAL scenario is at fault. Natural birthing with a midwife gets much better results. You won't see a can of formula in most birthing centers.

Originally Posted by elizaMM

Lactation consultants must be part of the problem. Even IBCLC's?

We have an IBCLC at our local hospital and yet half the mamas I know who birthed there "didn't have enough milk"! I know she is handing out nipple shields and formula (the former I think might be an acceptable last resort?) but why???

The local WIC nutritionist said "Our initiation rates are GREAT. But it seems like only the hispanic women can supplement without effecting supply." (what??!!)

Does the IBCLC certification process need to be improved?

Would this be a good lactivist statement to drop at every opportunity: "Don't listen to any lactation consultant who tells you that some women just can't make enough milk. (A VERY SMALL number can't, but most, with propper support, can make enough for TWINS!)"

Or maybe a mega-bumper sticker: "Women who 'couldn't make enough milk' probably didn't have enough support. SUPPORT BREASTFEEDING MAMAS!"?

Thanks y'all.

[fruitfulmomma]

Didn't read all of the replies but just wanted to say the LC at the hospital where 2 of my girls were born was great. I had had some minor problems with my son and she helped correct them. Also she was very pleased that I was still bf'ing him at 2 yo.

DD2 was NICU and was only given some solution off dh's finger, no formula! And I know there was a mom in there pumping for her preemie twins.

So I'd say it probably depends entirely on where you are at.