Laurie writes: "On another note, I think it is worth reminding all of us to always take a mother seriously who says the baby "just never seems satisfied" or is "hungry all the time." Sometimes it is just perception and everything is really ok. But it certainly bears a thorough discussion, and a weight check, even if the pees and poops seem ok."

I had  similar discussion with my co-worker yesterday.  It is the reason many of the moms I work with switch to formula, and so I wonder how many of these moms are truly having problems with supply.  I am supposed to provide phone support, and encourage them to keep going, yet how do I tell over the telephone if it is true concern or just perception?  I offer in-office visits, but many of our moms have transportation issues or just aren't that committed to breastfeeding to come.  

It seems to me that one of the most important tools the lactation world has is the weight check.  At current, our clinic process for seeing a new breastfeeding mom/baby does not include a baby weight check.  I am starting to think that it should, so that I have a baseline other than birth weight to work from.  I have been contemplating this for months, prior to this last situation.  I recognize it is only one piece of the puzzle, but it seems to hold everything else together.   

Thanks for this great discussion!
Lisa Paul, ICCE

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