After re-reading my posts on lactnet I wanted to add a couple points.

Re the phone triage logs: Excellent advice from Liz, of course. It stands to
reason that if one is counseling a mother with a breast lump, mastitis, a
jaundiced baby, or a low supply issue, one would be more specific in one's
notes than if one was counseling a mom asking questions about return to work
or buying a pump. So do be very thorough in your phone assessment and
recommendations and thorough in your documentation of these situations.
If time permits, it is beneficial to detail or list strategies recommended
or already tried, so that if mom calls again, and esp if she gets another
LC, there is plenty information and it's easy to continue the "story."

Re the complicated reduction scenario, this baby was at one time
breastfeeding and this mother wanted to feed at breast. Lest someone think
otherwise, I do not, in any way, want to convey the notion that long-term
expressing is not do-able nor worthwhile for mother or baby. I know there
are some on lactnet and others who have been quite dedicated to and
successful in providing expressed milk for their babies.

Laurie Wheeler RN MN IBCLC
Mississippi USA

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