This has been a great thread.  It is exciting to read Jennifer Tieman's
experiences and the suggestions everyone has shared.

I would like to add a couple of other tips that have helped me in my practice:

1.  Discuss feeding patterns during growth spurts and cluster feeding
patterns.  Many of my moms have assumed that they didn't have enough milk and
would start to supplement before I starting talking about this.

2.  Let moms know they can breastfeed if they are "sick" and that many meds
are safe with breastfeeding.  I encourage my patients to give me a call if
they have any questions about meds prescribed by their physicians (there are
a lot of pharmacists and physicians in my area giving outdated advice about
meds during lactation).  I make sure that I talk about this point and point 1
at the "3" day post discharge visit.

3. Ask when mom is returning to work or school.   Most times there is a "gap"
between the "2 week" and "2 month" visit.  Often during that time a mother
may have returned to work or school, started oral or injectible
contraceptives (just in time for a growth spurt).  I offer to meet with mom
and baby around one month of age to address these issues.  This seems to also
be a critical time when mothers wean if there isn't support.

4.  I like support groups and refer moms to local community resources.
However I also know many of my moms are not "comfortable" attending some of
these groups due to a variety of reasons.  I also ask a mother what kind of
"breastfeeding support" she has (other family members, neighbors or friends
who have had positive experiences breastfeeding).

Looking forward to reading more tips.

Pierrette Mimi Poinsett MD
Modesto CA

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