At the two week check up in my office (which follows a hospital visit by me
and a 48 hour housecall by my office's LC) I more than occasionally see a
baby two ounces or more under birthweight.  At that point, their confidence a
little shaken, I need to "sell" the mom and dad their baby.


My favorite question is:  "What color is his urine?" and my favorite answer,
I tell them, is "Umm .  .  . " --They're not so sure because they change and
pick up a pretty heavy diaper with no visible urine.

I then tell them that to get well-hydrated enough to pee clear urine an adult
has to drink large volumes and that obviously this baby is drinking a lot of
breast milk.  I then explain normal weight loss and the tremendous
UNIMPORTANCE of numbers in a baby doing well.  (I realize I am setting myself
up for a storm of responses .  .  . )  This assumes that the parents are in
touch with a supportive doc and a great lactation consultant.  To paraphrase
the late, great Dr. Jeliffe, "breastfeeding is a confidence game."  If we can
keep the family's confidence up, nursing will succeed.

I know that many people on this list may take care of families without great
continuity of care and therefore need some hard and fast parameters involving
number of wet dipes and so on.  Remedying this lack-of-continuity issue will
entail a revamping of our entire medical system and may not occur within our
lifetimes.

In the meantime, if our sales pitch is convincing enough, moms and dads will
buy the idea that this is a baby doing well instead of focusing on weights
and charts.

Jay Gordon

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