Dr. Mira
I agree with KB. Spend the 45 min giving the guts of bf "mgmt" e.g.
position, latch, milk transfer, how to tell if baby getting enough,
course of early bf. How not to interfere with this process. What to do
if baby can't nurse (feed the baby and support the milk supply).

Really, while you are talking about all this you can touch on sore
nipples (best to prevent and if they occur, refer for bf eval.),
engorgement (best to prevent). If you have time you could cover
mastitis/thrush (again, mastitis can often be prevented by not skipping
feeds etc) and go into the drugs and bf issue. If you can, you could
give easy handouts on sore nipple mgmt, engorgement, mastitis, thrush.
You could give them ph. nos. for bf specialists they could refer to. You
could let them know they could confer with you on any case.

If you still have time, you could say that whenever the mother weans she
should do so gradually. She should gradually decrease her supply to
prevent engorgement/mastitis and she should gradually change her baby
over to another diet. In this way the mom can relactate if needed.

In the event of a baby's death, the mother has several options. She can
express her milk and gradually dry up. She can be offered the option to
donate to milk bank. She can quickly dry up using cold, cabbage, sage.
Linda Smith had some very useful info on her website re drying up
quickly if needed. It is a wonderful website to visit.
I think it is www.bflrc.com but my internet navigator is not working,
only my email.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, USA
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