> What would you say to a group of pediatricians if they wanted guidelines in
> terms of when to refer patients to you?

    Any mother who is anxious about breastfeeding.
    Latch-on and/or audible swallowing has not occurred by 24 hours
             after birth
    Infant has loss more than 7-10% of birth weight
    Infant has difficulty breastfeeding (Latch-on and swallowing not
             consistent, feedings last more than 1 hour, infant is hungry
after
             most feedings)
    Infant over 3  days old who has inadequate output (Less than 3
              stools or less than 5 wet/urine in 24 hours)
    Infant has inadequate weight gain or has not regained birth weight
              by 2 weeks of age
    Infant displays signs of suck (nipple) confusion (accepts bottle but
              not breast)
    Actual or perceived low milk supply
    Mother is experiencing unrelieved pathologic engorgement
    Mother is experiencing cracked, bleeding, or blistered nipples or
              nipple soreness has not improved within 7-10 days
    Mother has flat or inverted nipples
    Mother returning to work and needs information on introducing
              bottles, scheduling, pumping milk while in work place, and
              handling and storage of human milk
    Induced or relactation lactation (adoptive nursing)
    Special circumstances (premature, multiples, congenital anomalies,
              neurological impairment, maternal illness)
       Family requiring time-intensive support and assistance

It would be wonderful if every mother was giving a length visit to fine tune
skills and teach on day 2-5 by a LC.  We offer this to all our breastfeeding
moms in our pediatric practice.

Warm regards,
Pat Lindsey, IBCLC - Lactation Services  www.PatLC.com
Pediatrics Plus' Staff Lactation Consultant   www.pedsplus.com
Orlando, FL
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