I am a hospital-based LC who also would  not be comfortable having this baby
go any longer without feeding.  This baby did not latch and feed for 2 days
and the mother and father were unable to judge effective latch and
breastfeeding.

I am thinking of  "Rule #1 Feed the baby" (Coach Smith),  and "a baby who
doesn't feed can't feed" (Barbara Wilson-Clay).  This baby had lost
considerable weight.  She was being discharged, so would not be monitored by
knowledgeable people.  She is in danger of spiraling downward and then not
having the energy to work to achieve good feeding.

Working in a hospital setting, with clients who have a variety of motivation
and knowlege, is different than working with clients who seek out BF help on
an outpatient basis.  I have heard from LC's who have worked mostly in the
community and then move into a hospital setting.  They are amazed at the
difference in challenges they face there.

Each client, each situation, each breastfeeding must be evaluated on an
individual basis.  I love to hear other suggestions from Lactnet members
about specific situations, but we need to trust the LC working with the BF
couplet to make the right decisions.

Barb Berges BS, RN, IBCLC
Rochester, New York

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