The recent thread about Anne's fussy baby offers good food for thought
for all the new LLLLs and LCs out there.  It is a small illustration of
how complicated it can be to try to solve a fairly common problem.  One
baby's overactive MER is another baby's chowfest.  Some babies will stay
at the breast indefinitely in an effort to get what they need while
others will come off quickly when the milk doesn't flow fast enough to
suit them.
Allergies, subtle birth injuries, chronic illness, prematurity,
facial/oral structure, drugs, and the ever-present influence of family,
friends, and culture can all be contributing factors in any given
situation.  It is rarely black-and-white out there, mostly endless shades
of gray.  It is what makes our field so interesting and unfortunately,
sometimes so frustrating.  It is also why clinical experience, mentoring,
networking, and continuing education are all so important - there are few
cookbook solutions to the problems we encounter.  So keep an open mind,
look for all the clues, consider all the options, and follow-up to see if
things are working out better.  Keep the mother (and yourself) sane and
the baby healthy.  And give yourself a pat on the back every day, even if
nobody else does.  Most likely, you deserve it.

Sharon Knorr
Lactation Consultant Services
Rochester, New York
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