What Baglady said. I work nights, and we have said over and over and over how much we'd love to have lactation work nights. We have bare bones staffing. No techs, no lactation and 4-5 couplets per nurse. If lactation would come hang with us on nights, they might have an inkling of what we're up against. Moms are overtired, babies want to nurse all night that second night, and there is no one but us to do everything...then we get told we're not supporting breastfeeding when we in reality we are doing all we can but don't have the time that's really necessary. Or they have a very hungry, dry, jaundiced baby that they're scared to supplement in any way because lactation told them not to.
I appreciate our LCs when there is a problem and they have time that I don't have to spend at the bedside for the entire course of a feeding. What I don't appreciate is when I have a hungry baby that has lost >10% of his birth weight, clearly dry and jaundiced, being raked over the coals for offering supplementation. I am an ardent exclusive breastfeeding supporter, both in and out of the hospital (breastfed two kids myself for 28 months and counting), but there are times when supplementation is indicated by the AABM. I don't appreciate being told I don't support breastfeeding when I suggest supplementation under those circumstances (and often with a physician order). That's why lactation gets the reputation for being the breastfeeding police. (For the record, I work with mostly wonderful LCs and there are only a couple bad apples that get under my skin.)
It is about the same with doulas - there are a few great ones, a few that are neither here nor there, and a few that irritate or overstep their bounds. For the most part, they are really great to have at the bedside because the nurses are mandated to do so much busywork to satisfy the bean-counters and it takes away from patient care.