Mimi- I'm so glad that Josh nursed well after his circ on day four.
However, I frequently see a different picture in my LC practice.  A call
I recieved yesterday  will illustrate a typical scenerio.  The mother of
a three week old calls in tears.  Her baby is taking more and more
formula- he is up to twelve ounces a day, now, and she is concerned that
he will soon reject the breast entirely- he is already showing bottle
preference.

Why does she give formula?  Well, he was born at 8lbs 3oz., discharged
at 7lbs 13 oz.  On day five he weighed 7lbs 7 oz.  On this day the
pediatrician's office stated that he needed to be supplemented after
each feed because of weight loss.  Then, at that same visit, they
CIRCUMCISED the baby.  After which he, as seems often to be the case,
and unlike your situation, he shut down for about 24 hours.  Meaning the
mom had a hard time waking him to feed, and he did NOT feed well.  But
of course, he got his formula, because now mom was worried.  Things
gradually improved at the breast, but the bottle is now on the scene.
In many cases, the baby is 4-5 days old, and still NOT latching, and
there was a circ done at around the time one would have hoped the mom
and baby would have been working hard getting nursing going but didn't
because the circ caused shut down behavior.

The way I see it is this:  Babies are born, and alert for a couple of
hours.  Then they often take a nice long sleep- as much as eight to
twelve hours.  Now mom starts teaching the baby how to nurse, and if
she's lucky she has a cooperative and able baby.  More often, perhaps
due at least in part to the ever present drugs and stressful labors most
mothers endure these days baby is to some degree disorganized, and needs
a good three to five days to get the hang of nursing.  But just at the
point when he is waking up and MIGHT be learning what to do, he gets
circ'd, and if this is at the time of discharge, there is all that extra
disruption associated with going home, settling in, seeing too many
relatives, etc. etc.

How can it be appropriate to circumcise a baby who has not demonstrated
competence at the breast?  How can insurance dictate what to me seems to
be innappropriate medical treatment timing?  I don't buy the idea that
the parents "want" this, because I always ask the parents who come to me
with this problem whether or not they were given the information that
the circ could delay the baby's breastfeeding competence, and they
always emphatically say NO!  Had they known it could cause BF problems
they say they would have waited.  Am I the only one seeing a lot of
this?

Sue Jacoby, IBCLC
California