Laura, I also run into this situation.  I too am interested in how others
might deal with this, here is how I deal with it:
If a mom says things are fine, and it obviously isn't, I simply say
something like " That's great, I am glad things are going well for you.  I
am here to review some important points to keep in mind so that you can tell
that baby is getting fed well and continues to get enough at each feeding.
I know that you have been given a lot of information as a new mom so a few
quick reminders might help."  Then I review 3 points.
And if she doesn't start asking me questions or getting my big fat hint that
she needs help after I have gone through those, I offer a follow up feeding
and weight check on the baby and we always give our card to new moms.  Then
I put her on a call back list for us to call mom 24-48 hours after discharge
to find out how things are going.  When we make those calls we ask mom 1.
how has baby been nursing since she went home. 2. how many wet diapers baby
has had in the past 24 hours 3. how many stooled diapers in the past 24
hours and what do the stools look like and 3 Does she have any blisters,
scabbing or bleeding on her nipples.  We offer necessary suggestions from
there.  Document document document.   If there is any reason that I am
concerned baby is not doing well, I tell mom why I am concerned and just how
concerned I am, whether a little or extremely. Then I tell her what I advise
( either, call pediatrician and get in to see them immediately or come in
for a feeding assessment or whatever the situation calls for).   I have not
run into a mom yet who has been advised to take baby to the pediatrician or
come in for a visit, who refused.



Pam Price IBCLC, CBE,
Lactation Department Coordinator
2nd Floor, Trident Medical Center
9330 Medical Plaza Drive
Charleston, SC 29407
(843) 797-4554 Breastfeeding Help Line

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