Hi Marilyn,
I'll suggest the things I see mismanaged (IMO) by peds all the time:
1. not knowing normal bf - ie Unrestricted bf, responding to fdg cues,
normal voids, stools. I get calls on Monday from moms who have babes not
stooling since Saturday and they are on day 5 and the doc just told them to
wait another day or give a suppository.
2. Jaundice - recently has been discussed alot. Do not have to interrupt bf,
but rather improve and protect the bf.
3. Meds - very very rarely will be incompatible w/ bf (I don't have many
problems with this one, but some do).
4. forgetting to protect the milk supply when there are bf problems - peds
docs are good about feeding the baby, but they often forget step 2 protect
milk supply and step 3 get the couple bf together. that's where the lc comes
in. also let them know that supplements if needed can be with ebm
(preferred) when available by expressing. again the lc comes in here.

I would suggest giving them a good bf friendly article written by an MD for
a med. journal (check our archives, I believe there are some good ones in
family practice journals). Bring in Lawrence text and the latest Clinics in
Perinatology devoted to bf (again, recently discussed) as gold standards.
Make sure they know that you and other LCs are to be referred to and that
good ibclcs work closely and collaboratively w/ the m.d. Check our archives
becoz there are alot of good replies to just this sort of question. Good
luck, and talk fast.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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