I agree with this statement that someone wrote: >I would like doctors to order lactation consults any time a baby has problems >related to feeding and not wait for days until the problem is severe and the >mother's confidence has been shattered. I think that often to the untrained eye, problems are not picked up early. If only the people who participate in the care of these mom's, e.g. staff nurse in hosp or doc's office, would know how to watch a feed and assess for milk transfer, do a good history, etc there would be better assessments of how Mom is doing. (The mother ofte does not know if there is a problem.) Then you the doc would know when to refer. I would say that a good precautionayr measure would be to refer anytime you are concerned about the jaundice, anytime any supplment is recommended in the early days, anytime Mom says her baby is not getting enough and weight gain is not 6-8 oz in 7 days, or when MOm says baby's eating all of the time and when you do a 24 hour recall of the feedings, she is nearly right,or when Mom lacks confidence. Hmmmm. what else. I know that referrals are a precious commodity in this day of managed care but it saves money in the long run. I think that the family practitioners are catching on to early referrals and I always praise for that in my follow-up note. Thanks for joining us in our work! Cindy RN, IBCLC, Lansing, Michigan's Capital MSU Grad Student