Hello Everyone, I have been coming accross some stumbling blocks and again need the advice of the experts. Three different issues. 1. Mother takes baby to ER, diagnosis Bronchitis. Baby is one week shy of one year of age. The physician states I can't believe you are still breastfeeding! In the instructions to the mother is clear liquids, absolutely no breastfeeding! He even circled it and had the nurse restate it for her as if she couldn't comprehend or read. Her baby wants to nurse and he is refusing other forms of diet. His rationale is that the milk will cause more thick secretions. The mother comes up to me very upset. I asked her can he breathe when he is nursing? She said yes. I asked her does he sound worse after he nurses she said no. I said give him the antibiotics and let him get the one nourishment he loves and needs. And he needs fluids as much as he will take. I asked her if she had a vaporizer or cold steamer. She said no. I told her that the warm shower running to steam up the bathroom may also help his congestion. I need some good references for composition of breast milk to show this man. If I have overstepped my bounds I guess I need you to tell me that too. 2. A patient comes into surgery for an exploratory lap r/o appendix. She also has a baby that is close to six months of age. The anesthesiologist is aware that she is breastfeeding before she even gets to OR. He tells her she won't be able to breastfeed for 48 hrs. Just a reference in Dr. Hale's book doesn't seem to be enough for these guys. I called the anesthesiologist and told him my understanding that with general anesthetic for these procedures that if she is awake and alert she can breastfeed. He compromised and told me 24 hrs. Are there protocols somewhere to assist these patients? 3. I have a 11 wk infant that has been gaining weight very slowly. The mom was seen by the peer counselor and referred to me after having her physician start her on Reglan. She works in a day care. She doesn't always get time to pump and at times tries to go and feed him the days he is there. The most milk she is pumping is 4 oz. I had her in my office and did a pre and post weight. Baby was up only 4 oz from one weeks weight check. He had nursed 2 hrs prior to coming to me. His weight was up only 2 oz. from that feeding. I have asked her to use a sns with the breastmilk she is pumping, so that he will obtain more calories per feeding. He is happy, he has good skin tugor, not fussy at any time. Nurses on demand at home and on weekends without supplements. I thought he was probably getting minimum feedings in 24 hrs. 6-7. He is growing in inches and head circumference. I had her try a whisper wear pump at work so she could be pumping throughout her day and not have to leave to pump. She said she got less than when she just goes and pumps 4 oz. in the morning. She will be in to see me tomorrow and we will evaluate the whisper wear pump whether or not it is effective. She has great nipples and breasts. Two siblings she nursed for 4-6 months with no supply issues. Thank you in advance. Please feel free to email me privately or post. Terri Klein RN CLE CLC [log in to unmask] *********************************************** 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