Dr. Amy, What you described is a very typical scenario, seen by LCs in hospitals every day. One can never be sure whether the nurse was pushing the formula or the mother was asking for it. The mother will tell you the nurse made her feel that the baby would get dehydrated etc and the nurse will tell you the mother wanted to sleep and did not want the baby. I believe it is a little of both. A vulnerable and not very confident mother will succumb to any subtle message or insinuation (even in the form of a question like how many times has he peed?) that she is not feeding the baby well. On the other hand, even very motivated mothers will give formula if it is readily available and if the baby is acting hungry and unsatisfied after bf. The first thing to do is check the position/latch/swallows/etc to make sure the baby is extracting well the available colostrum. I generally do not ask why the baby got bottles, but just ask a general question "how did the feedings go last evening and nite?" "how do you feel the breastfeeding is going?" "do you have any concerns about how the baby is feeding." These kinds of questions. Go from there. Mothers often tell me the nurses kept the baby and did not send it out during the nite. They just sleep I guess and don't ask for the baby. You have to give them anticipatory guidance that they have to let the nsy know that they will do all feeds for the baby. A small sign on the cot saying No bottles, no pacifiers helps. Encourage this, encourage rooming in. Ask if anyone helped them with the nite feeds, let them know to ask for help if needed. Let the nsy staff know that it is your expectation that mothers will be encouraged to exclusively bf, and assisted to do so. No, they won't have to MAKE the mother do it, but the whole attitude should be to facilitate that. Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA _________________________________________________________________ Express yourself instantly with MSN Messenger! Download today - it's FREE! hthttp://messenger.msn.click-url.com/go/onm00200471ave/direct/01/ *********************************************** 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