Dear Deena, I have spoken a few times about early discharge to MDs, because I feel strongly that the early discharge puts the breastfeeding 'into their court', and they stand a good chance of dropping the 'ball'. I have been very specific about what needs to be evaluated at the follow-up visit at day 2 or3. Actually, I just wrote an article that is in the first newsletter for the Academy of Breastfeeding Medicine that summarizes what I would say here...I would be happy to send it to you,...you would just need to send me your address. The hospital based LCs also should have alot of suggestions...the biggies are that the mother should be "resting between nursing", and not "nursing between rest periods". Mom should have very few, limited visits by others so she can really concentrate on feeding, and get into a groove with her baby. Definitely getting the baby to the breast within 1/2 hr is ideal...and no pacifiers. The other thing is that with early discharge, the mom has no time to learn the facts of breastfeeding.. It is the doctor's responsibility to make sure the patient gets educated prenatally. I think historically doctors have relied on the hospital experience as the training ground for breastfeeding, and perhaps that was OK (not really) for the old 5-10 day stays, but not now!! I am passionate about the changes that need to come about, and I would love to talk to you if you'd like. Oh, and one more thing....try to get them to do the circumcisions as an outpt when the milk comes in and baby is nursing well...and delay that first hep B shot if mom is hep Bsneg...I definitely have seen cases where that shot caused increased sleepiness. I could go on...Anne Eglash MD