Mira and All,
I also have been thinking about the problems that I see posted and
wondering if these are the worst of the worst cases.  Especially making
me cringe are the sore nipple problems, I rarely see truly damaged
nipples, a little soreness in the early days and lots of discomfort from
thrush are about it.  Also engorgement is fairly rare in our practice,
maybe it is nothing more than semantics but pathologic, obstructive
engorgement just hasn't happened in my experience at the Birthing
Center.  On the other hand when I was a WIC peer counselor (7 years
ago?) it seemed that everyone that I talked to was suffering from
engorgement.  So is this about prevention?  Our women get good,
consistant information prenatally, home visits, phone calls and weekly
weight check clinic postpartum. We also have a lot less interventions at
births, since Midwives do the deliveries.  I am definately going to
start keeping track of the IV fluids in labor as it relates to weight
loss in babes.  I see alot of babes that don't lose much at all and then
a few who lose close to 10%.  It has made me wonder why.

Janie Ginder RN
Eugene, OR