I found Rachel Myr's comments to be extremely beneficial to this
discussion and I agree with her.

I would approach the mother in a similar way. ALL mothers should know
the signs/symptoms of effective vs ineffective breastfeeding, and
in a perfect world ALL mothers would have followup.

If this is not in place in your facility, I would urge you to try to
get some type of followup started, if at all possible.
All the teaching you do and the written info you give can still go
unprocessed and babies do get in trouble with parents not recognizing
that.

Over the many years I have worked in this field, the programs I have
worked in, or started up from scratch (2 programs) have evolved to
have, first, just phone followup. Then, phone followup plus targeted
outpatient appts, and now I have outpatient clinic appts
offered/encouraged to all bf dyads on approx day 3-5 (some moms refuse
followup appts, mostly multips).

The phone followup is the very least, but I will say that parents
quite often (in my experience) misjudge jaundice, wetness of diapers,
infant lethargy, infant gassiness (hunger), constipation vs low
intake, and whether or not they are experiencing copious milk
production. There is simply no substitute for in person evaluation,
guidance, and support. This is the gold standard.

Laurie Wheeler RN MN IBCLC
Mississippi USA

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