Jane says:



"My question is this:  why are not the pediatricians and other healthcare
providers providing this service where the baby has a medical home and an
ongoing record?   One of the big problems with scales is when you weigh baby
on different scales and get different results, causing mom needless anxiety
or occasionally unjustified confidence.  This is not just about liability,
but is about responsibility also."



She is absolutely correct.



This is why it is imperative for IBCLCs to be employed in pediatric and
newborn primary care provider practices or immediately available in the
community upon referral. Not to sound like a broken record, but "Licensure
and Reimbursement" are the avenues to making IBCLCs standard of care from
breastfeeding couplets. Until there is a means in the U.S. to pay for our
essential preventive healthcare service, babies are at risk of weaning and
other health risks. Physicians and other HCPS who are not trained in
lactation management do not recognize the risk factors or warning signs for
poor feeding. If he baby is gaining well in the first week they may not be
seen again until 1 month of age. The peds do not  typically assess mothers
at all for risk factors for insufficient lactation or breast nipple
problems.

I have had an older babies (3-5 months) referred to me that had gained
inadequately all along. The pediatricians only told mothers to supplement
with formula. This is a 30 year old problem that is repeated over and over
and over.  One baby was admission to the hospital with a work-up costing
many thousands of dollars which identified the cause of failure to thrive as
poor breastfeeding!!! Duh! Lactation support is imperative as are regular
weight checks until breastfeeding is well established.



We shouldn't have to offer "weight checks" out of the realm of the PCP. They
need to follow the breastfeeding newborns more carefully and provide
appropriate lactation care.



Judy Gutowski, BA, IBCLC










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