Heather asks:  "I ask again,  why would a properly qualified person instruct a mother 
to limit bf in this way?"  ["this" being feeding on an every-3-hour schedule] 



The problem is we don't actually know what was said to the mother about feeding  frequency  She might have been told "no less often than every 3 hours" or "babies usually eat every 2-3 hours" or "every 1-2 hours during the day and every 3 hours at night" or a dozen other things.  And possibly she did literally get a "feed every 3 hours" instruction. 



When I had my first child, I was induced due to my own illness.  It was an all day induction when I hadn't had more than a couple hours sleep the 2 nights before, so by the time the baby was born at 10:38 pm, I was exhausted.  I got to my post-partum room around 2 am and was given a number of instructions by the patient care aide, like how to use the hand-held sprayer for peri care and the pads and lovely mesh underwear .   She also said something along the lines of "don't be surprised if the baby sleeps a lot and doesn't eat much in the first 24 hours." 



In my total exhaustion and post-partum fuzzy brain I know in retrospect that  I interpreted this as "you don't need to feed the baby for 24 hours."  Not exactly a good translation of her actual comment!  As a result, I did not put the baby to breast much that first day, and we spent the next 3 days trying to catch up and get her latching well (and pumping and doing some fingerfeeding when she didn't latch). 



In my case I was fortunate that my daughter didn't have a worrisome weight loss and that my supply was destined to be generous  [Even in the hospital I was able to pump an oz on each side at ~36 hours PP] 



Anyhow, my point is that while the mom may have "heard" that she should feed every 3 hours, what was actually  said may have been very different.  [I also see this in my general practice, where patients return to the office after an ER visit and I know full well that what they're telling me cannot possibly be what the ER docs - some of whom I know well - told them, even if it's what they heard.] 



Rather than directly contradict what anoth er provider has said, I'll often offer a suggestion of an alternate interpretation - e.g. "I think what the nurse meant was that you shouldn't go longer than about 3 hours.  Babies often want to eat more frequently than that, and if the baby wants to eat, you should go ahead and feed her!  Here are some ways she'll show you that she's hungry ..." 



We definitely shouldn't jump to conclusions about the capabilities of other providers based on the oral report.  I like Rachel's suggestion t o get a written copy of instructions from the other provider where possible.  If indeed mothers *are* getting instructions such as a strict q3 hour feeding schedule, that suggests some re-education is in order. 


~Spencer (MD and LLLL - I know my instructions have been misheard and misrepresented more than once!  Where feasible, I give written notes or follow up w/ an email for my LLL calls) 







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       E. Spencer Joslin-Montlick, MD 

            [log in to unmask]   



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~Spencer (MD and LLLL - I know my instructions have been misheard and misrepresented more than once!  Where feasible, I give written notes or follow up w/ an email for my LLL calls) 







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       E. Spencer Joslin-Montlick, MD 

            [log in to unmask]   



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