Yes, truly I am feeling homicidal!! Today I had a call from a mom I had
helped while in the hospital. She started by telling me how everything
was going with breastfeeding.  Her daughter is now 1 week old, is
nursing every 2 - 2 1/2 hours, is a little fussy at night if she's in
her crib alone, so she brings her to bed with her and they sleep much
better. Birth weight 7#9 oz., at home visit on day three - 7#0, today in
the ped office 7# 14 oz. Lots of wet diapers and yellow stools and baby
is satisfied between feedings, no engorgement, no sore nipples, baby
latches on well. She then asked me how I thought bf was going.  I told
her that if everyone did as wonderful as she was doing, I would not have
a job!
To my dismay, she began to SOB!!! She had just come from the ped office
where between the Dr. and his nurse they had spent 30 minutes telling
her everything she was doing WRONG!!  She was informed that the baby had
not gained enough weight, and if she didn't gain the right amount by
next week, she would have to supplement. (They didn't tell her how much
was enough, just that 5 oz over birth weight at 1 week old wasn't
enough!!!) They told her that she was nursing entirely too much and she
must wait four hours between each feeding. If she nurses at two hours
the breast is EMPTY, at four hours, she will have enough.  Also if she
has to supplement next week, that will actually improve her supply as
her breasts will have time to become engorged!!  And she is NOT ALLOWED
to ever sleep with her baby again.  If she cries in her crib, don't even
enter the room for four hours, as she will become spoiled!
I am appalled!  This ped has been in town for approx 1 year and I am
aware that he certainly does not support bf'ing from his orders in the
hospital, but this is the first time I have heard this info.  I have to
assume every other mom that was given this advice listened and failed at
bf.  This particular mom is knowledgeable and well read about bf and
knew enough to question this advice.  We talked about bf management and
I believe this mom will be running, not walking to another Ped.
I immediately went to this physician, and nicely requested to provide a
lunch and learn session to his staff, reviewing the latest AAP
guidelines, at no charge to him. I thought I could get in the office and
provide the latest info on bf management.  He adamantly refused, stating
he doesn't agree with babies ever nursing more frequently than every 3 -
4 hours as they spit up too much! He stated his staff provides the bf
info he wants parents to follow and they don't need any education!
Next, I went to the chief of peds and asked for his help in reviewing
the AAP guidlines in the next ped meeting and encouraging them.  He will
do this but states that in the office, a doctor is "king" and he has no
say over what is done.
So, now I'm back to square one.  We have been working very hard in the
past few years to become more bf friendly and have definitely begun to
improve bf rates upon discharge.  Any suggestions on where to go from
here??? (short of homicide!!)  TIA  Sorry this is so long.
Wendy Krzanowski
RNC  IBCLC  CCE