I was just about to post an update about my little jaundiced guy from last
week when I read this in Magda's recent post about test-weighing:

<<  In my experience, whenever someone starts meauring something about
 breastfeeding:  weight, fat content of milk, length of time at the breast,
 number of times up in the night, the horrible story of someone syringing the
 milk out of the baby's stomach, etc. there is a negative impact on how the
 mother experiences breastfeeding.  >>

This was a baby who I think ought to have been weighed -- forget test-weighed,
just plain old weighed  -- earlier than his ped asked for it, but because I am
not certified in any way I had no role but to advise the parents when they
wanted advice.  When the mom's nipples hurt it was easy to persuade her that
the baby wasn't nursing effectively; I was able to correct the latch and she
now enjoys nursing.   But once she was pain-free she was persuaded that
everything was fine, and politely declined all further comment from me,
jaundice or no.   The upshot is that at 2 weeks the baby had lost nearly a
pound from discharge; he now gets offered a bottle of ABM post-bf, slurps it
ups, is gaining weight, getting pinker, etc.

I was very ambivalent when I heard about this.
On the one hand this was clearly a case of Rule #1 -- time to Feed the Baby.
So that was a relief -- I knew the kid wasn't getting quite enough, but the
ped was able to persuade them when I wasn't.
On the other hand I wish to God he had suggested to the mother fixing the bf
along with the supplementing -- no pumping, no SNS, no fenugreek heaven knows,
no evaluation of baby's swallow that I heard about, no referral to an IBCLC,
etc.

Ultimately, I have come to realize that for this family this is probably the
best thing one could realistically have hoped for.   This mother strongly
associates pumping with the disastrous trauma of her first child's
hospitalization, which led to zero bf of that child.   Pumping for this one
would, for her, be like flashbacks -- she just hates the thought. This child,
on the other hand, is getting some of his mother's milk and lots of his
mother's snuggling, and the mother is getting at least some idea of what
basically non-traumatic bf might feel like.  And if -- as one sadly guesses --
early weaning is in this kid's future, well, honestly that's more bf than I
ever expected in this family.   That's why I was thinking about Magda's post
copied above:   in this case it would have been great to do some measuring to
help protect exclusive bf; but since that wasn't possible I could at least try
to protect a happy feeling about what bf there was.

So two questions for the assembled wise ones.  First, it is clear to me in
dealing with this case why it is a good thing to be certified and therefore
able to deal with hcps.    But it is also clear to me that this family would
NEVER have gone to someone certified -- because they are medically oriented in
a way that say, If I have a problem I need to go to a Doc -- I can only get
help from Elisheva when I need mother-to-mother support, not "real" help with
a "real" problem.   And that is in a nutshell my whole population -- people
who for this kind of reason will *never* call an IBCLC or an LLL.   So my
first question is, Any good ways for me to gently persuade these folks to get
the help they need?   When the baby is in danger alarming them is the answer;
but usually the doc is going to see the baby in a day or two, so the kid isn't
going to starve; he's just going to have lost 2 oz and get supplemented b/c
the bf wasn't fixed enough to do without.

And secondly, closely related, any good ways for all of us to gradually
undermine this sociological prejudice against getting this kind of help?   Do
we just keep working on the pediatricians, Sources of All Baby Wisdom, or is
there a way to get to the parents about this too?

--- and again thanks to all who emailed me privately with advice about this
family; I only wish I had been able to implement more of it.

Elisheva Urbas, bf fifth columnist in NYC