Denny,

I'll put in my 2 cents' worth about what seems to me are the handy-dandiest
materials I've learned about over Lactnet:

Massachusetts Breastfeeding Coalition's early breastfeeding triage tool
looks excellent to me:

http://www.massbfc.org/providers/MBCFlowcharPRINT.pdf

Be sure to let them know they have a PDA version!

Kay Hoover and Barbara Wilson-Clay's Diaper Diary is fantastic for the first
week.  Providing it to their patients may save a lot of alarmed-parent
calls, depending on how much education the birth attendant provided:

http://www.lactnews.com/ddiary.html

I LOVE the full-color illustrations.  No amount of lecturing in childbirth
classes can anticipate the reaction of parents who have never cared for a
newborn to the realities of normal diapers.  I have no financial interest in
this product and no personal acquaintance yet with Kay and Barbara, but the
images are so striking and the diaper log so user-friendly for
sleep-deprived parents that I want to direct attention to it.

I think the triage tool and Diaper Diary or similar materials you may have
developed are great for starters, so they'll know when to refer to an LC.
You can give them a good overview of what LC's are able to do when all is
not OK. And of course this is the big point to make -- EARLY FOLLOW-UP is
crucial to prevention of lactation train wrecks.  (And may be crucial to
dealing with health or developmental problems undetected at the hospital
that feeding problems may indicate.)  When a pediatric practice is hired by
a pregnant couple, they should make it clear that visit #1 should be early
in the first week.

As for dealing with patient breastfeeding questions in later months, I
naturally think the best thing to refer pediatric practitioners to is La
Leche League.  LLL's online catalog can give them a good idea of what's
available in lactation literature.  Be sure to get information from your
local Leader for them to give to patients.  Many LLL groups have information
online, and some can email peds with an attachment of their brochure to
print out.

Power to you for being proactive!

Ruth Piatak, LLL Leader
Plano, TX

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