I've been in rapid skim mode on lactnet recently including some of the
tongue tie messages that I didn't completely digest.  But I had a recent
success that stemmed from gearing up into ped report mode.  We've had to
cope with the Elizabeth Seton Childbearing Center closing (after I just
started there in April), shifting over our address and building up a
private clientele separate from the Elizabeth Seton reputation.  So, now
I've attacked the pediatrician reports with a vengence and I've been taking
out my frustrations by writing one page reports.

I had really great success with an older pediatrician that I'd previously
put into the "hopeless" category, but through the process gained a great
deal of respect for her.  First, one of the clients I had seen called with
a baby that had lost well over a pound.  I was obsessing about how horrible
it would be when I saw this emaciated baby and mom who had barely started
pumping.  The pediatrician was completely unconcerned.  A good lesson in
watching the baby and not the numbers - this baby looked terrific and
downed 1.8 oz in nothing flat because mom was an overproducer.  He was in
really great shape and I am dead certain that the weight drop was
measurement error.  BUT he had ankyloglossia that limited mobility in
lateralization, extension and up and down.  Mom's supply was carrying him.
So I wrote a nice report and the ped said let's wait and see.

Mom subsequently got mastitis in one side, her supply dropped by 50% in
that breast, and the baby stopped gaining as well. She had plenty in the
other breast, but hadn't been feeding very frequently during the mastitis
because she felt so rotten.  So, with a little finger feeding and judicious
pumping - he was back up to normal.  So I wrote another report and
accompanied it with bullet points of my concerns - the suck was actually
worse, mom's supply had dropped, potential for another round of mastitis if
milk statis occured due to poor drainage, etc.  I didn't say anything about
tongue clipping but did mention someone who was an expert in this area that
our clients had liked.  So, the ped said "well, in my day we never did
these" but this is making a lot of sense and referred to a specialist. She
told the parents how pleased she was with my reports and started referring
to us.

Susan Burger, MHS, PhD, IBCLC

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html