1, about dehydration: agree with Deena's post but would like to add a few
pearls based on my experiences teaching the stuff:

        1. No evaluation of dehydration is very accurate: you can tell
its a little, bad or very bad but would not venture in assessing how much
as a precise measure because most are wrong and it may influence y our
management.  Even weight can be tricky to interpret: different scales may
cause error and in the case of children fixing to have diarrhea their
weight may be the same but all their fluid in their gut! So technically
they may be very dry but have not lost weight yet.

        2.  A physical finding I find helpful in assessing infants and
children is skin temperature.  As you blood volume decreases you clamp
down small blood vessels to the unnecessary organs like the skin to
preserve things like heart and brain,  this cause a prolonged capillary
refill as Deena pointed out but also the skin to be very cold.  So
assessing the temperature of the skin gives me info about how well
perfused the patient is: cold hands and feet= mild dehydration; cold to
elbows and knees= moderate, cold all over, pale= severe almost or at
point of shock.


2.  Working mothers:

I couldnt agree more with Deena about some of us mothers working for the
love of it! it is certainly my case: medicine is my passion and one of my
favorite hobbies.  However..... In particular now that I have a brand new
baby, working presents still a conflict for me.  I love what I do and
dont think I would be happy not doing it.  I love my kids and hait to be
away from them, in particular to be separated from my infant and miss
nearly all field trips of my older one.  Working in itself is not the
problem in my opinion, it is the context in which we work, that so far
dictates pretty much an 8-5 job with in my case some 80 hours weeks when
on call, the lack of tolerance of babies in the work place and lack of
tolerance and trust for options such as flexible time, work from home.
My boss has a tendency to assume that if youre not there youre not
working and nothing can be farther from the truth!!!!.

So I'd like to propose that we start changing the world so that it fits
our need rather than forcing mothers to comply to a rigid work schedule
and assume that moms work best if separated.  This has to be tailored to
each person (not every one is comfortable working with baby in tow!) but
I meet many wome who do not inven consider child care on site in their
office as a possibility!  So lets become imaginative.  Perhaps some of
you can share their solutions to having the best of both world. As far as
I am concerned, I have taken my newborn to the office except one half day
so far.  People are so used to seeing me with baby in the sling that when
I didnt bring her, they all asked why she didnt come!!!!.  Even do clinic
with her, worked out great.  (of course would probably not want to do a
general ped clinic because of exposure to infectious diseases!).

Looking forward to further discussion

My moto for BF mothers who are a little scared of what people would say
is : do it until someone tells you not to. Someone once said its easier
to apologize than to ask permission.  I rarely do things like every one
else and believe me I rarely had to apologize.

Maryelle