Lactnet,
Thanks so much for the encouragement from so many of you. Just to let you
know that, yes, I do bring in the pump, am revising policies, making some
small changes re meds, maternal fever, etc. My boss and I are seeking
volunteers to work on bf policies. So far one taker. I appreciate all the
suggestions, but still I have to wonder, why do we LCs have to go so far out
of OUR way to get bf and simple baby friendly practices accepted and
supported?  It's the same old argument, why should we have to show the
evidence for every little thing? You can tell I'm still a bit disillusioned,
altho I'm haven't quit yet.
Re BILI
I had a conversation with Jack Newman via email about bili and formula vs
ebm. He says what you say, Nancy, that a dr. could argue for formula becoz
ebm could unconjugate some of the bili - but only after mature milk is in
like at days 5-8. Therefore with early jaundice due to lack of feeding, the
unconjugation is not occuring with the early milk. Is this right or wrong? I
understand about breastmilk juandice and even a combination of the two types
of in later days. Also, what about colostrum and breastmilk having laxative
effects, wouldn't that help? And of course, how much difference would it
really make in terms of the numbers and of course don't forget the risk of
losing the bf altogether when mom and baby are not bf for a few days. Babies
I am talking about are day 2, 3, 4. Welcome discussion on this important
matter.
Laurie Wheeler RN MN IBCLC
New Orleans LA USA

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