Thanks for the clarification, Lea, and the nice analysis, Christine.  I wonder if the next steps here may be reassuring the Mom, complimenting her for being so in tune with her baby, providing some information about evaluating baby's breastmilk intake without a scale, and suggesting a week of breastfeeding on cue without weights.

I too feel the pressure of wanting to give Mom an answer when she comes to me perceiving an issue.  And the fear that I may have missed something.  I have, on more that one occasion, told a Mom, "You are doing a fabulous job and I can see how perceptive you are about your baby's needs.  She is so lucky to have you as a Mommy!  I do not see any red flags here - she is growing beautifully and voiding well.  Nonetheless, I have much faith in a Mother's instincts.  What if you try xyz and lets touch base in a few days to see how you are feeling about this?"  along with some more specific information about whatever the concern is.

Throughout this, I'm really careful not to confirm a Mom's perception with my language if it may not be fact.  So I'd avoid saying, "I'm not sure why it seems like your supply is plummeting." rather "Let's talk about what you are seeing that makes you feel as though your supply could be low."

Lea - please let us know how you make out with this!  Or perhaps you'll come across some more information to add to the mix that will send us down a different path.

Christine - I also love the team approach - both for the Mom AND me.  In my office I see the Mom and baby first and then they are seen by a physician IBCLC.  It is very reassuring for all!  My colleague was just interviewed about this in the ILCA "Clinician in the Trenches" article http://lactationmatters.org/2012/02/14/clinicians-in-the-trenches-diana-jordan-ibclc/ .  It's a good read!

Ellen

Ellen Rubin, MA, IBCLC, LLLL

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