>I recently saw a mother with 3 days old baby (36 wk). The mother 
>thought that breastfeeding was going great, milk came in and she was 
>feeding every 3 h ( she was instructed to do this way in a hospital 
>by lactation consultant).
>The baby was jaundiced, sleepy and lost 9.5 % from birth weight.

A 36-weeker, jaundiced and sleepy on day 3 with this sort of weight 
loss (would be regarded as WNL in the UK, actually!) is what we'd 
expect with 3 hourly scheduled feeding.  For most babies, this is not 
enough, and scheduled feeding is *inimical* to happy, effective 
breastfeeding.

This mother may well have had hypoplastic breasts - but the 
sleepiness and weight loss and lack of effective feeding is *entirely 
consistent* with the baby simply not feeding often enough. All babies 
need unlimited skin to skin contact with their mothers, and no 
separation, and certainly no advice to schedule (ie *limit*) feeding 
to 3 hourly.

What would have happened if instead of supplementing straight away, 
this mother and baby were encouraged to be together in physical 
contact all the time, with some informed and observant assessment 
made of how effectively the baby was transferring milk? Could the 
situation have been left a couple of days,  assuming the baby was 
basically well (may have needed treatment for jaundice, I know, but 
this would not effect or interrupt skin to skin)?

I am not picking at Maya's assessment - just asking in a spirit of 
genuine enquiry.

I also want to know why someone in practice thinks it's a good idea 
to 'instruct' a new mother to bf 3 hourly.  Can this ever be 
appropriate?

Heather Welford Neil
NCT bfc, tutor, UK
-- 
http://www.heatherwelford.co.uk

http://heatherwelford.posterous.com

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