Hi Susan, 
I think there probably is a higher readmission rate right now, but I think a major reason is the poor breastfeeding management that occurs in most hospitals. What I see where I work, and I think it's typical of a lot of hospitals, is nurses still encouraging mother's to breastfeed every 2 to 3 hours. I keep trying to tell them that this results in fewer feeds for the baby, but they don't listen. It gives the parents a false idea that these babies are going to only want to nurse every 2 to 3 hours, so what happens is that the parents try to hold them off instead of feeding them on demand. They will give them a pacifier and say, oh he can't be hungry. He just ate 30 minutes ago. And as a result we have babies missing tons of feeds. Or sending the baby to the nursery overnight with a pacifier to hold him off when he's supposed to be cluster feeding. All this pacifier use also results in the baby having a shallow latch at the breast which results in nipple
 pain and poorer milk transfer contributing to jaundice and slow weight gain. Most hospitals also do a poor job of teaching mother's proper positioning, latching, how to know if baby is swallowing, signs baby is getting enough and who to call if there is a problem. Also, I think that there is a lack of understanding that some mild level of jaundice may be normal in infants. We tend to over treatment jaundice, in my opinion, and in the opinion of the Academy of Breastfeeding Medicine. They have a great protocol for hyperbilirubinemia. So we have a baby that missing lots of feeds, which delays mother's milk coming in, baby has shallow latch and transfers little milk, mother is not taught the things she needs to know - what's going to happen? Of course you are going to wind up with dehydrated, jaundiced babies. It's not breastfeeding's fault though, it's the poor management of breastfeeding that occurs in most maternity units and the lack of education about
 breastfeeding for mothers. The answer is better management of breastfeeding for healthcare providers and patients.

Sincerely,

Tricia Shamblin, RN, IBCLC

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