Theresa These are common scenarios and frustrating for the LC and mom. However try to remember the physician is doing what he/she feels best for the patient based on his training. It is your job to run interference, so to speak, if you can, to remedy the situation to preserve bf if possible, educate the physician, while not alienating the physician in the process. 1. year old infant w/ bronchitis - I would say something like some physicians beleive milk will thicken mucus secretiions, while others don't; breastmilk is not a dairy product-milk; and it is not formula. let her know many physicians are not familiar w/ the differences. You may be able to find some refs abiout the mucus debate. If you have a book like Jack Newman you can share that one. Personally I would rarely outright say to ignore the dr's advice and do something else, but I rather let the mom come to her own conclusion. Let her know there are differences of opinion, esp. that he's an ER doc. 2. mom w/ appendectomy - The anesthesiologist is probably very unfamiliar w/ breastfeeding medicine. You can share the Hale info w/ mom or the Dr. Newman type info w/ her. You can perhaps involve the pediatrician if he/she would be more knowledgeable. You can let her know that the anesthesia is not at work since she is awake and alert now and therefore it is metabolized/metabolizing. Again, let her draw her own conclusions. Do not force any of these issues, it can get you into alot of trouble, even the mom may report back to the MD, esp if the baby happens to throw up or something and it gets blamed on untimely bf. 3. slow gainer at 11 wks. - go back to square one with this dyad. Do a good history. My guess is that she needs to nurse more - have the baby in close proximity whenever she can; be faithful to her pumping, use a good quality pump. the amts she is pumping (4 oz)and the amt the baby consumed at one feeding (2 oz) don't sound esp. worrisome to me. I think it might be the total time bf/pumping that is the problem. Other questions to ask: any other foods, water, pacifiers, mom's meds, birth control meds; any health problems; etc Laurie Wheeler, IBCLC, MN, RN Tupelo Mississippi, s.e. USA *********************************************** 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