Just to share.
I got a call the night before last from a grandmother. She said her daughter 
and brand new grandchild were staying with her after birth and the baby 
wasn't nursing well, the mom was engorged and they were concerned. Since it 
was late, very late, I gave over-the-phone advice on engorgement and said if 
things hadn't improved by the morning she should call me and I would come 
over. (I didn't tell her take two asprin, though)
The next day she calls at 11 AM but I coulnd't get there until 2 PM and here is 
what I found:
Four day old baby girl, born 40th week, normal pregnanacy, no medication at 
birth (amazing!) 2.3 kilo (!), New mother is small and very fine boned with 
breasts large for her size, almost flat nipples that point downish (if that's a 
word), mildly engorged. Baby was sleepy and floppy and she hadn't had a wet 
diaper for 6 hours and wasn't really having them and no bowel movements! 
(Mild panic sets in) We're in the middle of a heat wave here in the dry 
mountains of Jerusalem. the baby was in two layers and under a blanket and 
the room was stifling. (Panic rising) So I said to myself if I can't wake this 
baby up, I'm sending them to the hospital.
I stripped the baby and she woke up and was actually quite alert (whew) I 
had a quick peek at her mouth and gave her to Mom.
Mom tried cross-latch, baby rooted and rooted and couldn't seem to latch. 
Mom didn't seem able to hold her close. Tried classic nursing position and still 
no go, baby getting frantic. Calmed baby down and tried football hold, still no 
go. So,
I requested lots of pillows. I had Mom remove much clothing (She was wearing 
a zip up robe and a t-shirt underneath) and recline on her back on the pillows 
with baby on top of her, tummy to tummy, straight up and down her body. 
Baby stopped crying at once. It took twenty minutes, but the baby was calm 
and active the whole time and, you guessed it, she self latched. (It was 
gorgeous to watch)
The story ain't over.
Baby's suck was inefficient. She clicked and you could see she wasn't getting 
milk, which there was; Mom's other side was dripping. I decided to wait and 
see. Baby unlatched and latched a couple of times herself and each time the 
latch improved. After an hour from when I came this little darling was nursing 
beautifully! (wheee!) and she did it all by herself (so to speak).
I was still worried. (what can I say) So I left the following instructions:
Baby must have fluids every hour no matter what. I showed her how to spoon 
feed, stressing that first we try nursing. She must nurse at least every hour 
and a half, even a short nurse. If she wants to stay latched she can stay all 
day, please. Absolutely no bottles or pacifiers (She'd gotten a couple of 
bottles) If she does not have two lovely wet diapers by 9 PM, then they have 
to go to the hospital (I'm sorry, but I'm not a big risk taker) From midnight, 
she can nurse every two hours;  grandma and Daddy can give baby fluids in 
between. If Mommy feels that she is going to fall to pieces if she doesn't sleep 
she can take on three hour break with Grandma and Daddy on duty. (I did 
show her how she can nap safely in the reclining nursing position) Lots and 
lots of skin-to-skin. No clothes on the baby until the end of the heat wave, if 
it's cooler at night they can put on a t-shirt. (I'm telling you that room was 
hotter than an incubater) Mommy was very happy to comply.
She called at 6 pm. One wet diaper. Baby spit up what looked like her entire 
meal. I said as long as we have nice wet diapers, don't worry (Because of my 
concern and belt-and-suspenders, schedule she may have been over-fed for 
her stomach capacity)
She called at 8 pm. One wet diaper and a bowel movement. 
She called at 10. Another wet diaper. Baby looks much livelier, not sleepy at 
all! Nursing nicely, ten minutes at a time but fairly often.
Well, ladies, isn't that happy-making? Just thought I'd share because I love 
sharing happy stories.
Here's wishing you your own happy stories, one right after the other. 
Comments welcome.

Yael Edelstein ICEC BFC

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