I believe that we SHOULD voice our concerns to the mother if we think, suspect, feel, etc. that a medical problem exists. While we aren't diagnosing, I think that we need to make it clear to the mother that she MUST consult a doctor. Case in point: during a telephone consult, the mother told me that she had been treated for vaginal strep perinatally; her three week old was now fussier than usual (which CAN happen at three weeks) and she had strange sensations in her breast. My gut feeling was that the breasts weren't draining well; however, I also felt that since there was a history of strep, it was IMPERATIVE that the mother let both the pediatrician and obstetrician know that she was experiencing some kind of symptoms. The mother was totally unaware that this could be a serious infection in the baby, or that she could have a mastitis caused by strep. The problems resolved with better feeding positions, and there was no strep, but I slept better knowing that she had consulted with physicians. Pearl Shifer, IBCLC