Hello,
       My name is Debra Vander Weit.  I work as an RN at a local hospital
here in central Florida.  Part of my job includes seeing new moms  in the
first weeks home from the hospital.    Our hospital has just recently begun
offering this service to new mothers.  I must tell you I find it very
rewarding but also challenging.  I am not certified in lactation counseling
 although I have done a fair amount of continuing education on the subject.
  I also nursed my own two boys til eight months and twelve months
respectively.  I kind of wish I had had someone around with my first to tell
me what to do about biting.  He drew blood and I just couldn't bear to put
him to the breast again.
But anyway...   I am just wondering if you may have some answers for me.  As
I am seeing moms and getting telephone calls from moms with five and six week
old babies,  I am finding my knowledge limited.
        So here goes:    I have a new mom with a six week old infant.  This
mom came to me at six days with literal scabs (the size of a pencil eraser)
on both nipples.  We got her past this with teaching proper positioning and
all was well.   The scabs have healed and baby is nursing well and gaining
weight.  Today she called me saying that the baby wants to nurse continually.
 She will nurse forty minutes , take a ten minute catnap and nurse again for
forty minutes.  Mom says this goes for four hours at a time,  and then the
little one sleeps for four hours.   Does this sound like a growth spurt?   Is
baby building up supply by nursing so much?   Mom also complaining that
breasts are "bursting" by time baby wakes.  According to mom this pattern has
been going on for last four days.  She also said that baby has been letting
go of breast during feeding and crying and she has trouble getting her to
latch on again.   I have read that if it is a growth spurt that milk is
usually increased by 2-3 days of increased stimulation of nursing.  Do you
find that it is longer sometimes?
       Question #2   I saw a new mom with four day old infant.   Breast milk
was "in with a vengence" and baby latched on well.  As baby nursed  we could
hear a clicking noise with swallowing.  I have been taught that clicking
noises are not a good sign.  To the best of my knowledge the baby had his
mouth opened well, tongue down and over bottom gum line at time of latch on.
 The bottom lip remained flanged outward.  Nursing was not painful  etc...
 So what do you think?  Do we have a problem or not?

        Thanks for any help.  I am really enjoying reading all of the posts.

Debra Vander Weit RN