We have to understand not many parents educate themselves about the basics of breastfeeding.  Then, how can we expect that they notice when the baby is not doing well?  
   
  I have seen more than my share of failure to trive babies to understand the facts.  How many parents I have seen that find normal that a newborn eats only twice or 3 times a day. A lot of pediatricians see the baby 5 days after delivery and tell the parents it is normal that the baby looses weight, not bothering if its more than 7%.   Then they schedule the next appointment for when the baby is 1 mo...too late for intervention.  The AAP encourages pediatricians to see bf babies often in the first month.  I dont know if locally there is a language barrier, since our first language is Spanish, but I cannot mention even one ped who follows this recommendation, not even fellows!!!
   
   If the baby seems jaundiced (by looking and him and not ordering labs), they tell the parents to sunbath...many times I have to call a pediatrician myself in order for him to place a lab order, to find out later a baby with a billi of over 18.  Then they tell the parents the cause is something in the mothers milk and never in their minds they think it is lack of it.  
   
  And last...when the parent calls concerned about the baby not stooling, the pediatrician tells the parents it is "normal" for a bf baby not to stool often.  Im not going to let only the pediatricians get all the bad rap (hate to generalize), as I have seen the same things done by phone counselors.  Im just using them (pediatricians) as an example of what I have seen done as missmanagement of bf.
   
  In conclusion, many times it is not the parents fault, but the combination of missinformation that causes this type of problems.  It is essential that the parents educate themselves prior to the baby's delivery about the basics of bf (we have to promote prenatal bf education); that bf educators (in general) teach new parents how to recognize if the baby is receiving enough; we as lactation consultants have to promote baby's evaluation and follow up early after delivery.  
   
  Carmen Cabrer, IBCLC, RLC, LLLL
  [log in to unmask]
  www.lacted.com
  lacted.com/blog
   
   
  ~~~~~~~~~~~~~~~~
I wonder if the parents merely noticed that the baby was becoming a =
"good" baby, the sleepiness and lethargy being perceived positively?  =
Mothers with extremely busy lives and inexperience - ending up being =
negligent by default.  One of my local colleagues, Janette Tyler, has a 
=
fine presentation based on case histories on this sort of situation, 
and =
presented it at ILCA in Sydney in 2003.
Virginia
in Brisbane
~~~~~~~~~~~~~
Heather Welford Neil wrote:

The question is what eactly is going on in a family where this=20
happens and no one notices the half-starved looking baby that results.

Imagine: a 5 mth old thriving baby who starts being underfed to this=20
extent will  change his behaviour in some way, perhaps by=20
crying/whimpering/yelling more than usual. As the starvation=20
progresses, he will become sleepier and of course a lot skinnier.

And no one notices?






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