I wish doctors knew that breast milk jaundice is usually not apparent until
at least a week of age, and that it is seldom if ever necessary to interrupt
breastfeeding because of jaundice.
I wish doctors knew that fingerstick blood sugar machines are inadequate for
diagnosing hypoglycemia at the low ranges normal in newborns and that blood
sugar in the first day of life is probably 30 or above (Lawrence).  I wish
they would order central blood sugars for babies thought to be hypoglycemic
(and put baby to breast while awaiting results if appropriate).  Most doctors
(and nurses) feel giving formula is a benign intervention and therefore feed
the baby formula based on a low chemstick rather than doing a central blood
sugar.  In fact, the word from our NNPs and neonatologists is now
"Hypoglycemia should be prevented, not treated."  So now a baby who doesn't
go to breast within 6 hours or who has not breastfed in 6 hours or has any
risk factors will be fed formula if the heelstick glucose on an Accucheck
machine is 41, 42, or 43.   (Sorry for the tangent.  [the bookstore idea is
sounding better and better]).   We often get normal central glucose readings
from lab after the baby has been diagnosed as hypoglycemic by chemsick.
I would also like doctors to know that just because a baby is dehydrated and
jaundiced, it doesn't mean the mother doesn't have enough milk; it just means
the baby isn't getting it.  Maybe they could even LOOK at the mother's
nipples and WATCH the baby breastfeed before they decide what intervention is
necessary.  (Incidentally, looking at mom's nipples prenatally and checking
for eversion would also be helpful.)
I would like doctors to order lactation consults any time a baby has problems
related to feeding and not wait for days until the problem is severe and the
mother's confidence has been shattered.
I wish that doctors would ORDER no bottles or pacifiers and order alternative
feeding methods if supplementation was necessary.
Thanks for caring and thanks for asking and especially thanks for taking on
this most important task.  I am sure that you are already doing the most
important thing, which is to teach these doctors that BREASTFEEDING IS
IMPORTANT.  Then they won't worry about making mothers feel guilty.  They
will do everything they can to encourage breastfeeding and avoid as much as
possible anything that could interfere.
Bonnie