Pam
Sorry I am playing lactnet catch-up....but regarding the doctor telling the 
parents that the baby does not need the 4am feeding: This is common 
pediatric advice. It will be hard to find proof to convince mom baby does 
need it. However the LC can provide general bf info and ilca evidence based 
info regarding the way bf always works - on cue feeding.
The mother should be helped to learn that lots of peds docs (in my 
experience) are fairly rigid in their feeding advice, prescribing xx ounces 
over xx hours and teaspoons and tablespoons of various "baby foods" at set 
intervals. This mom would greatly benefit from going to mother support or 
reading a mother support type book (LLL for example) so that she can 
continue to follow baby's cues. Let mother and father know that if they do 
omit the 4am feeding they will have to hear the baby cry and deny him the 
breast which  is a gut wrenching experience. Moms and Dads, at this point, 
are often tired and it does sound good to just believe you can eliminate 
that feeding and everyone will get more sleep but it doesn't work like that. 
Good counseling skills and empathy/listening is needed here. Especially w/ 
Dad.

Laurie Wheeler, IBCLC, MN, RN
Tupelo MS, s.e. USA

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