Hi friends, so glad this list exists. I had one of those head 
banging days when I started to think maybe I'm getting too old 
for this. I decided to take a deep breath and try to make 
lemonade. Yesterday I was given a referral to see a mother 
and baby ( I work for a home care agency) When I called the 
mother said she wanted the referral but the infant had lost so 
much weight that the doctor, said don't breastfeed for two 
weeks ( the infant is 4 days old), pump and give formula and 
come back for a weight check in 9 days! I told the mother I 
would speak to the doctor as I didn't think I could do a consult if 
the baby wasn't going to the breast. This was a usually 
supportive of breastfeeding clinic. I spoke to the doctor, who is 
new and asked if she wanted me to do the consult, she 
confirmed, the visits have to be made in a certain time frame 
for insurance. She wanted me to show the patient good latch 
techniques and follow the previous advice. We talked a bit 
about the babies weight, baby had actually gained 2 oz from the 
day before when nurse visited but there was confusion with 
reporting. We talked about poor transfer not breastmilk possibly 
being the culprit (I know it was) for weight loss and jaundice 
and that the patient would probably have very poor supply 
pumping only with hand pump for 2 weeks etc .The doctor said 
she would call the patient with the new plan,breastfeed followed 
by pumped breastmilk if available  until I see them and I will 
call with weight and transfer weight. I felt a little better. Today 
when I went to the WHO site re/ new growth charts, decided to 
call the new clinic manager, introduce myself, offer info on the 
new charts and the ILCA conferenceShe was more than 
receptive, very supportive of Breastfeeding, very concerned 
about what happened yesterday,may sent staff to conference. 
       It gets better! She would like an inservice in the fall for 
nurses and MD's. Would like to explore a way for LC's to be 
more involved in the clinic. 
       That finally leads to my question. She asked about quickly 
referenced Breastfeeding books for the nurse who  do phone 
triage.They have to be able to acces info quickly I suggested Dr 
Hale's Medications and Mothers milk as well as the web site and 
the Breastfeeding answer book any other suggestions? Thanks 
Chris Erland
           

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