Deena,
Thanks for the excellent assessment reveiw.  I believe well prepared nurses
 also assess and look for most of the signs you included.  My recent
observation of nurses working with mothers and newborns is that they are
teaching parents about "observing their baby's (number and contents of
diapers - whether damp or wet, color, consistency and amount of stools, baby's alertness/state, particularly long baby
sleeps between feeds, color (has it changed?), skin turgor and response to
breastfeeding (audible swallows, deep attachment, etc.).  Many of us have been
encouraging use of cloth diapers until parents become confident baby has
adequate output.  The call that stimulated my question to LACTNET was from a
student who is looking for a comprehensive measure to use in research.  A
systematic method of assessing baby's hydration status would formalize the
process...she is hopeful that one is available so she can use it and get on
with her MS...  I'll relay your points to be assessed.

Have you seen an increase in numbers of dehydrated babies in your area?  NJ
has set the trend for extending hospital stay.  I enjoyed your other
comments on yesterday's (8/3) digest.

I was particularly touched by your comments regarding maternal employment.
 We still (no matter what our backgrounds) are still so polarized on this
issue.  My children are now adults but when they were small I was in school
 and eventually employed.  I finally got my PhD when the youngest graduated
from high school.  My dissertation dealt
with maternal separation anxiety in mothers of second-born infants (as you
might expect, in most aspects anxiety went down with the 2nd)...Mother's
who were doing what they wanted to do (either staying at home or employed
 outside the home) were much happier than those who felt they
"should" be doing otherwise.  Dissonance is a big problem.  Today (10 years
later) I do worry about the growing numbers of women who must return to work
 before they feel ready to.   Many mothers tell me (I have a small pump
rental station now) that breastfeeding when they return home from their
"outside" work really is special.

I thought your comments were timely and well stated.
Martha (Columbus, Ohio) Pitzer, RN, PhD
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