Greetings everyone! I need some expert advice and good suggestions :)...
 First, I have been assisting a mom whose fullterm baby was diagnosed with
an intestinal atresia, subsequently went to surgery and now has been
diagnosed with cystic fibrosis. She has been pumping and puts the baby to breast
whenever she visits. The baby nurses pretty well, is totally off IV fluids
and receives bottles only when mom is unavailable. The problem is that the
baby is losing about 30gms (1 ounce) every day and Peds Surgery and the
parents are concerned. The baby is not on enzyme supplementation at this
time as they are going to do another battery of tests to confirm initial
sweat test. Mom seems to have good supply of milk-usually gets 3-4oz with
pumping about every 3 hours and gets only 1/2 oz after nursing. When the
baby is bottlefed, takes a max of 85ml
every three hours. Anybody have experience with this type of baby? Obviously
the parents want to continue breastfeeding but are concerned about failure
to thrive. I have the info from Riordan and Auerbach and Ruth
Lawrence-haven`t gotten to the journals yet!

 Second, I will be giving a talk to Peds residents and medical students on
the basics of breastfeeding.  Any ideas on how to get them involved,
enthused, interested? Not only am I going to breeze through the basics, but
I thought I`d touch on problem areas like breastfeeding and hypoglycemia,
jaundice, and prematurity. Any suggestions would be appreciated!

 Lastly, I have had a multitude of sleepy, disinterested fullterm babies who
do not want to nurse. This is a tertiary care OB center so we have a great
deal of intervention going on in Labor and Delivery. My question is this-how
long do you allow the baby to nurse poorly without intervening. My NICU
background has me looking at
voids and stools and baby`s physical appearance and behavior and I`m usually
ok with it for the first 12-24 hours if baby looks ok. The OB nurses and
Peds have varying opinions. What do all of you think?  Generally speaking,
when should pumping and supplementation begin?

 Sorry all I`m doing is asking, asking, asking....but you`re the best
resources I have and I respect your experience and wisdom!

Lisa Logan RNC,IBCLC (who has been just a wee bit too stressed out lately to
think straight ;) )
Maryland,USA