To Kathleen Auerbach:  Don't despair!  For several years now I have been
seeing the mothers in my practice who are breastfeeding 1 week after birth,
and since all the hoopla in the press r.e. "that breastfeeding can be
dangerous" I have started seeing moms anytime from 1-3 days after they go
home, depending on latch on, weight loss, and etc.  The nurses in the well
baby nursery I run are instructed to teach mom the 3 most important signs
that the baby is getting milk (at least 5-6 urine outputs in 24 hrs,
transition of stools to "cottage cheese and mustard" within 3-5 days of
birth, and audible swallowing by the 5th day).  MOthers are also given
business cards of mine, and my nurse practitioner and are instructed to call
for ANY concern.  For my practice, I find this works pretty well.  I also
see a fair number of babies in the nursery who go on to see other
pediatricians in the community; and what I instruct these mothers to do is
to request an appointment in 1-3 days if I think there is a problem and in 1
week if things seem to be going well, and I forewarn them that they might
encounter some "surprise" that I want the doctor to see their child so soon.
I empower the mother by telling her that breastfeeding success is enhanced
and promoted by close follow-up and that she should EXPECT her pediatrician
to feel the same way.  If you want to hear more, Kathleen, I'd be happy to
go on, but this is getting too long so I'll stop for now.


Terry Lynn Dise, MD
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