Here is a long post of things from a nurse who you may wish to inservice one day: first,
I think you can get a lot of your answers by re-visiting that very heated thread. Try to see past all the emotion expressed there really try to understand what we nurses have been saying. Staffing issues are a HUGE factor in how much attention breastfeeding problems receive in the hospital, especially on nights and weekends, where I work. It is not fair or just, but if we are "slammed" it is hard to place breastfeeding problems at the top of list of priorities. But when someone calls for help BF, I make is a priority to get to that room and help her any way I can. I put it up there on the list of my priorities with pain control for my patients and try to be there within 5 minutes of their call. Or I try to find a less busy coworker to help her. I do all I can but sadly, it is sometimes not enough. I am always happy for moms who deliver during the week --if they have severe problems, they can see our LC. She is an experienced L and D nurse who is also A certified LC. She can be invaluable during our busy times. Plus, she DOES initiate follow-up calls to each breastfeeding mom who delivered at our hospital after they are discharged home.
That said,here is how I initiate breastfeeding for ALL moms in my care who are willing: Immediately after delivery, often while the placenta is waiting to be delivered, I put the baby to breast if he/she is doing well. I do all in my power to ensure the baby is at breast within the first 15-30 minutes following birth. I often get moms who say "no give him a bath first" . When they do, I tell them it is best to breastfeed first as the first 30-60 minutes are when baby is most receptive to nursing and bonding til he/she gets sleepy and lethargic for 4 hour or so. There is PLENTY of TIME for bathing and shots in 30-60 minutes. Many nurses ARE stuck on the "nursery" routine, however, insisting bathing and shots be done before everythign else. I try to encourage nurses in the delivery room with me to "let go" of that and let baby nurse first. To me it is critical.
I already SAID the NUMBER-ONE ELEMENT OF SUCCESS (or sadly, failure) in breastfeeding is the MOTHER and her ATTITUDE. IF she is COMMITTED (as are her family members to support her), she is much more likely to succeed than the one who is NOT dedicated to breastfeeding. Attitude determines much.
Yes, nursing staff attitudes are HUGELY contributory. I would be a fool not to acknowledge that. And there are "lemons" out there. (referring to nursing here). NO doubt. But you are not seeing them HERE from what I can tell. And the majority of nurses I work with are COMMITTED to ensuring breastfeeding success with each and every family who desires it that is in her care.
If you want to have an inservice to improve breastfeeding success, great. One thing you can emphasize is CONSISTENCY. I hear a lot from my patients that they get VASTLY different information from each nurse who cares for them. This concerns me. I understand there are many techniques and ways to succeed out there, but I think lack of consistency frustrates patients. Short of making very firm and clearcut policies regarding breastfeeding and mandating regular attendance at breastfeeding seminars/classes, I don't see this changing much. Unfortunately, the information we get changes oftentimes, too. We are taught many philosophies and beliefs and the "latest" info always has something new to try. I guess it would be best if we all got this same info and used what helped consistently. It is complicated and complex.
But I still stand by what I said; it begins with attitude. The MOTHER's, the family's and the that of maternal/newborn staff. IF they come to me FIRMLY COMMITTED TO BREASTFEEDING AND ALL THE WORK IT INVOLVES, trust me, I will do all in my power to ensure they succeed. I like to think that is the attitude of the vast majority of us nurses.