Laurie:
I do a lot of phone work with WIC and so I understand what you're
looking for. You're right, in my opinion, to want to have something to
go by when the client is not in front of you. Being on the phone in
this business, I always say, is like trying to conduct gall bladder
surgery over the telephone; it's not your fault you can't fit the
scalpel through the phone line. So for what it's worth my own rule of
thumb is if the mother is a) complaining about how long the nursings are
taking AND b)they're at least an hour long.
That's a full hour or more actually at one or both breasts. I ask this
repeatedly to make sure she's not counting diaper-changing time,
burping, etc.
If I hear that, I want to see her. I want to see her for two reasons:
1) if she's complaining then she needs some help or she'll quit nursing.
2) Any child that *actively and effectively* suckles and swallows for a
full hour or more is, unless something's wrong that hasn't been
determined over the phone, (all the more reason to see her - to be sure)
going to DROWN in the amount of milk his mother made in that hour. I
almost invariably find that those hour-plus newborns are in fact NOT
eating effectively and mom can't tell the difference between active
eating and sleeping at the breast. Usually they will also say that the
minute they lay the baby down, he's awake and hungry. Yes, of course he
is. He probably only spent about 5 minutes eating and then spent 55
minutes sleeping.
Some of these babies seem to fall asleep after the first letdown.
So if they're upset about the length of feeds, and those feeds are fully
an hour or more in length, I see them....
Regina Roig Lane BS IBCLC
Miami-Dade County Health Dept
WIC/Nutrition Breastfeeding Program
7785 NW 48 St, Suite 300
Miami FL 33166
786-336-1333 x162
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-----Original Message-----
From: laurie wheeler [mailto:[log in to unmask]]
Sent: Wednesday, September 20, 2006 3:05 PM
Subject: reply to length of feeds
Ann, I appreciate your input and take on this.You are right, I had all
the info I needed becoz it was an office visit. I could look at the
small amt of urine, and the yellow color., and i could observe and do a
test weight. I don't know about you, but I do not get good reliable info
from moms over the phone. Invariably they do not think the baby is
jaundiced when he is, they count many pees but they don't realize how
small they are - I even ask how heavy they feel (the diaper) and other
probing questions about the output. anyway, I know what you are saying
about timing feeds, I don't advise timing them, but getting a
description of a feed is helpful I think. The "effectiveness" of the
feed is most important, yes, and that is what I am trying to determine,
if it is a phone call. From observing babies feed at breast for 24 yrs
or so, I guess my opinion is that typically a hungry robust baby will
feed pretty quickly altho some feeds may be leisurely too. So I guess if
a phone call is about lengthy feeds I would want that baby in for a
visit and wt check. Laurie Wheeler RN MN IBCLC
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