Maryelle,
Thanks for the comments on how you assess babies for dehydration.  Skin temp
and color are certainly easily assessed and should be core to any
systematic physical evaluation.  Your point that weight may not change
because of fluid shifts (to abdomen) because of diarrhea was something I
hadn't thought of---. It has been 15 years since I taught peds, I do
remember about the rapid fluid loss and that ill, dehydrated babes often
look gray.  As an LC in hospital I see babies in the first few days of life,
most are just fine but we do worry about sending them home, especially if
breastfeeding hasn't gotten well established.  More and more mothers go home
pumping...as I'm sure you see also.

Your proposal about changing the world to fit the needs of mothers rather
than expecting mothers to conform to rigid rules of society is something I
expect you'll get many LACTNETTERS to agree with.  I certainly do.

Congratulations on taking your newborn to work with you.  By doing so you
are a role model for other current and future mothers.  Several of my academic
 colleagues have done this with mixed success -
appears easier in the early months (great for breastfeeding) but harder
when baby becomes more active or mobile.  Usually one of the faculty
(nurses) or many students always seemed to be there to help out when mom had
to teach class or conduct a conference.  There were also the grumpy faculty
who didn't applaude the solution.

I recently encouraged a police dispatcher to pump at work (she has no office &
was sure her super wouldn't allow it).  The supervisor didn't balk and mother and baby
 happily continue to breastfeed exclusively.

Our university has a large, well staffed childcare program...waiting list is
long but many students, staff and faculty find it great.  The past two years
I have been LC at a hospital which has childcare on the grounds.  Some staff
go to the center to nurse their babies....hard to do within a busy schedule,
but lots try to feed once a shift and pump once or twice, depending on stage
of lactation.  We also have a "mother's pump room" with 3 pumps, rockers,
etc. (no windows or very cheery environment, I'm sorry to say).  Hospitals
usually are ahead of the rest of employers in regards to supporting
lactation.  Are you aware of the Sanvita program through Medela?  This is a
corporate program to assist mothers pre and post delivery with
breastfeeding.  Anyone out there in cyberspace involved in Sanvita care to
elaborate?
Sorry this went on so long.
Martha (Columbus, Ohio) Pitzer, RN, PhD
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