Laurie writes:
 
"The phone follow up is the very least, but I will say that parents quite  
often (in my experience) misjudge jaundice, wetness of diapers, infant 
lethargy,  infant gassiness (hunger), constipation vs low intake, and whether or 
not they  are experiencing copious milk production. There is simply no 
substitute for in  person evaluation, guidance, and support. This is the gold 
standard."
 
My hospital's telephone follow-up program of about 23-25 hours per week got 
 the ax three years ago in the first round of what turned out to be 3 RIFs 
in  about 2 years. This was a great loss to the mothers in our area.

The very  skilled CLC/CCE who did the follow-up is now a per diem IBCLC in 
our facility. I  am able to make  only a few follow-up calls daily, usually 
to  those mothers who have left with identified risks or problems, or to  
those I am calling as follow-up that I thought was necessary after an  out-pt 
consult.
 
Many mother and infants in our area still receive an MCH visit from one of  
3 home care agencies in our area. It is not quite as automatic as it used 
to be,  but still provides a level of follow-up that other areas of the 
country may not  be as fortunate to have. I know from attending conferences and 
speaking with  other IBCLCs and visiting nurses ( I used to be one) that we 
are a rarity in  that this is still fairly available in our area. 
 
I am starting to educate mothers on just concentrating on their infant's  
stooling pattern after discharge, and not worrying so much about the wet  
diapers, and show them exactly the size of a "good BM." I tell them that if  
their infant is stooling appropriately as I describe, then they will most 
likely  be urinating in a sufficient amount. LLLI (LaLecheLeague International) 
has a  good handout on this that I refer to. We do give out our own feeding 
and output  sheet that parents can log on, but I wonder how many of them 
really use it. 
 
Mary-Jane Sackett, RN, IBCLC
Pittsfield, MA
 


             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome