It is very discouraging to hear of so many places where postpartum follow-up
is so inappropriately and dangerously late.  At the Kaiser hospitals here in
California, babies are scheduled for follow-up two days after discharge.  At
the hospital where I work, they are seen by an RN who is also IBCLC, or in some
cases by home health nurses.  Before discharge, we LCs at least "touch base"
with every mother and baby.  The ones who are having breastfeeding difficulty
or have excess weight loss get a feeding plan and, in most cases, a
hospital-grade breastpump.  Even with all this, we get a few babies at the two-day
appointment needing to be re-hospitalized for jaundice (and we don't hospitalize
until close to 20 for full-term babies) and/or dehydration!  Sometimes the
parents are not following the plan, sometimes a baby who seems to be doing fine at
one or two days of age is not fine at 3-4 days.  As has been mentioned, it's
most often those 35-38 weekers that get in trouble.  I can't imagine how it
would be if they weren't seen until 2 weeks!  Miriam Levitt RN, IBCLC

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