Hello friends,

Just wanted to share a good day with you all.  A baby was readmitted to
our inpatient pediatric unit for failure to thrive.  The baby was 7 lbs
6 oz at birth and now two weeks later is 6 lbs 5 oz.   Mom has breastfed
a previous child successfully and all looks well when the nursing
session was observed. Taught her to do breast compression (thankyou Dr.
Jack) and reviewed her nursing history which was unremarkable.  Baby has
had 3-4 seedy yellow stools per day.  Anyway, after I saw the mother and
baby, I went out to discuss my impressions with the dr. who ordered the
consult.  He turned to me and said with great sincerity, "Would you
recommend supplementing this baby? Is there ever a circumstance when you
would to that?"  This is the same MD who on my first meeting with him 4
years ago, honestly admitted he knew nothing about breastfeeding
(despite having done an Infectious Disease fellowship at a prestigious
local childrens' hospital) and was open to anything I could teach, give
him to read, etc.  I knew then that he was a rare breed.  His final
recommendation was to do pre and post feeding weights for a few feeds
(baby gained 2.5 oz after the feeding I observed) and to continue
breastfeeding ad lib.  I suppose that supplementation MAY be ordered if
this conservative approach doesn't yield a wt. gain in a day or so.  But
my long winded point is that he (a) ordered a consult (b) did not rush
to fill the baby up with ABM (c) respects the mothers wishes not to
supplement - yet.

This happens rarely.  I am hopeful that another pediatrician will follow
in the breastfeeding friendly shoes of Dr. Jack, Dr. Wight, Dr. Rob and
all the others in your community.
Thanks for listening.

Mary Alice Tinari, MSN, IBCLC
hospital based LC in suburban Philadelphia, PA  USA