Jean Great post on the 20% wt loss. I agree that is ALOT and not very likely to be normal. I really appreciated your forthrightness saying you needed to hone your telephone triage skills. I would love to be able to see all the babies at day 3-4 but telephone triage is the next best thing I guess. I agree with you that you have to ask very specific questions, somewhat open ended, and leading a bit sometimes. Like you said asking the exact amt of the pee and poo. I usually ask is it about a tsp or tbsp or more. Describe the poo poo to me. Is the pee clear or very pale. Is the pee dark, tea colored, or pink? I also ask if the baby has ever peed on the mom and they usually say yes and I ask was it a good stream (a fountain) for a boy or a good puddle for a girl, and they laugh and say yes! that is a good sign. If they are not sure if the baby is peeing, or scant poop, bring them in. I also ask about jaundice, if the staff told them the baby had some and what to do, and if it appears more or less. (Beware parents are not good at assessing juandice, lethargy, wt gain or loss etc IMO). There is alot to ask and it is a judgement call really how they are doing. Sometimes it is very clear they are doing well; sometimes it is very clear they are doing poorly, and sometimes you are not sure. Sometimes I will give some recommendations and call back next morning, sometimes bring them right in, sometimes recommend supps of ebm/formula until can be seen. Coming from a hospital setting and nicu background, maybe I err a little on the side of caution but it has served me very well. Often catching babies that would have fallen thru the cracks, as we say. Today had a 36 wker now 4 days old who reportedly bf poorly 1st 12 hrs or so, then was bf well (not seen by LC due to lack of w/e coverage). I recommended she come in to be evaluated since b.wt was 5 lb 11 oz and discharge wt 5 - 7 and baby was 36 wks and bf not evaluated by a skilled hcp IMO. Today wt was 5 -3 and very jaundiced. Mom has been using hosp grade rental pump but not getting much at all and the supps she was giving was about 25% short of what baby needed each day. Called peds and sent to lab for stat bili and peds visit. Luckily the baby was hydrated, alert, and caught in time, I believe. Just want to say as well that I appreciate Marie's points and also Tina's 'babies can latch by themselves' thread. I try to integrate all of this into my practice which is art and science, remember, and sometimes it is a tough call. Remember my motto: Live and learn. Laurie Wheeler, RN, MN, IBCLC Violet Louisiana, s.e. USA _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html