Typical Day for Inpatient Lactation Consultant?

**LibraSunCNM, BSN, MSN, CNM** · Jul 11, 2014

The IBCLCs at my former job (Baby Friendly hospital with ~5000 deliveries/year) worked 9-5ish. All nurses got to shadow a day with an LC so I am pretty familiar with their schedule. They would generally round on moms in the mornings with specific issues that we RNs had referred them for. Then between 10 and 12 daily, there was a formal breastfeeding class for any mom having issues/wanting extra support, with sometimes up to 12 or 15 moms in the class. Each LC ran the class a little differently, with some more hands-on than others. In the afternoons they would do more rounds on people they had met in the class with issues. They were also responsible for renting out our hospital grade pumps for anyone who wanted to rent one, selling pumps/pump parts/nursing pillows/bras/Hydrogel pads to anyone who wanted them, and for answering messages left by moms on our breastfeeding support hotline. On a good day we had 2 LCs so that they could split up the work. In terms of documentation, if they consulted with someone at the bedside they filled out a fill-in-the-blank, pre-formulated note in our EMR. If someone came to the class, but didn't need a specific follow-up, they didn't chart on them. Hope that helps!

AZwannabe · Jul 16, 2014

I am currently working as a PRN LC. My day is typically 9 until everyone is seen. Sometimes that is 3 pm, other days it is 6 pm. Moms are seen in order of severity. Whether they are waiting on discharge, pt request, nurse request or physician order, we still try to see the most urgent first (e.g. baby hasn't fed, mom is cracked, bleeding, etc. ) We try to see all breastfeeding moms at least once before discharge.

We document every visit and list observations, referrals, and teaching. Other duties include committee work, in-services, weekly breastfeeding support group, phone calls from discharged moms, calls from med-surg floors with lactating patients. Let me know if you have more specific questions.

iPink, BSN, RN · Jul 17, 2014

At my hospital, the LCs work M-F 9-5. They don't see every mom, only the ones we (the RNs) ordered a lactation consult on. We consult lactation for reasons such as breast augmentation, inverted/flat nipples, latch difficulties (even after we helped work with mom), or per patient's request to see one before d/c. The reason why the LCs don't see every mom is because we are a large Women's hospital with 12-15K births/year. To educate 30+ moms in a day is a lot for one LC, which is why we need to have valid reasons for placing a lactation consult. I got the opportunity to shadow her one day and she's amazing. AZwannabe pretty much sums up the day of a LC, except our Breastfeeding hotline and out-patient classes are done by a different group of IBCLCs. Once they have seen the patient, the LC charts a narrative about the help/education they gave the patient and spouse/significant other. She can spend between 10-30 mins with each patient, or more if need be.

RNIBCLC · Jul 17, 2014

My day starts at 9 also. Azwannabe pretty much describes my routine except I stay til 7 pm. Along with the postpartum moms, I may assist with first feeds in recovery area.

NicuGal, MSN, RN · Jul 20, 2014

Ours work from 8a to whenever. Our Breast is Best committee requires them see every mom who is breastfeeding at least 2x before discharge on the postpartum floors and at least twice weekly in the NICU. And we have a 50+ bed NICU and two 20 bed floors....and two LC. I always feel bad when Inhave no choice but to call them when I have a first time mom and a really sick kid...really sick kid takes precedence over the other one and if they can't come over that poor mom is left to her own devices. Sucks. I wish hospitals would set their budget to include more LC's. We had staff nurses become certified, but they were always pulled back into staffing.

The reason for the mandated visits stems from a lawsuit in which the hospital lost. Kid went home, dehydrated, became kernicteric, seized and is now MR/DD. Mom said no one ever came in to make sure baby was eating okay.