Another post from Cathy Liles, brought to you by Kathy Dettwyler:

Howdy again,
I had another interesting visit yesterday. A baby who had lost more
than a pound below birthweight at 10 days. When I got to the house,
there was a copy of the "Womanly Art of Breastfeeding" and a book by
the Ezzos on the coffee table next to a digital timer/clock.  I
assessed the baby and the breastfeeding and found that there was poor
latch-on, a tight frenulum, but tongue seemed to come out far enough
on digital exam and we talked about her everythree hour schedule.  The
baby had been sleepy and they had been waking her for feeds every 3
hours and nusing her 10 minutes on each side and then each side again
for 5 minutes.  She fussed when offered to nurse on the left.  We
talked about baby's needs and how some baies need to eat more often
than every three hours and be allowed to finish one side and thenoffer
the other- she seemed open to the suggestions. We got the baby
latched-on very well and she had a good nursing session with lots of
swallowing and I talked about baby cues non-stop while she was feeding
and I talked about the need of baby for closeness, when she was held-
she realxed so much she didn't seem interested in feeding. I suggested
that they add a couple of hors a day of skin-to-skin time to meet her
obvious need for closeness and she seemed to like that idea and felt
daddy would love to share in that. The MD had told her to BF 10
minutes on each side and then offer formula in a bottle for 10
minutes.  I was careful not to contradict his recommendations nor put
down her scheduling plan, but I talked non-stop baout how to read her
baby and how important it was to watch the baby more than the clock.
She is pumping and collecting an ounce or two og milk after each
feeding, but was not supplementing with her own milk because the HCP
had said formula- I suggested she call him about substituting her milk
for the formula as supplement.  I am hopeful that she will now fill up
with mom's milk at the breast and not be interested in the formula. I
am also hopeful that my teaching on cues and mother's intuitiom will
help her override her desire to follow a dogmatic schedule. The best
sign I thought was when she forgot to look at the clock and then was
upset but then noticed how content her baby was to still be nursing.
Little by little.  Thougt you would be interested in how this was
handled wthout addressing it directly.  Cathy Liles