Dear Friends:
    I remember the surprise when I made the transition into hospital LC work
from my private practice. Shock is a better word, and growing compassion for
hospital LCs in the US.
    My recommendations for what to do with mothers (and families): put babies
s2s. Actually doing this teaches more than any words or checklist.
    Teach the mother to nurse in a position of her choice and comfort. Bring
the baby in to her, once she is comfortable. Comfortable = a position she can
sleep in. The pillows are used last, to support her and make a nest.
    Teach her that her job is to bring the baby to the table and that the
baby's job is to pick up the fork. That is, her job is to bring the baby to the
breast. The baby's job is to latch.
    Teach her to hand express and feed the newborn milk via spoon, after
10-15 minutes of s2s. She can do this every hour or two until she and her baby can
connect.
    Teach her feeding cues so she knows when to bring baby to breast.  She
has to keep baby close to watch for the cues.
    Teach her about being a placenta for a few days, as her baby is weaning
from a continual feeding pattern to an intermittent one.
    Teach her to look for poop color changes. The Shrago study reinforces
that baby should have yellow poops by 5-7 days.
    Finally, give her a list of places she can get help and call her up twice
in the first week (the day after she gets home and one more time) to make
sure things are going well.
    While doing this, give her praise and encourage her to took at her baby
for answers to questions about feeding frequency and duration.
    warmly,

Nikki Lee RN, MS, Mother of 2, IBCLC, CCE
Adjunct Faculty, Union Institute and University, Lactation Program
Film Reviews Editor, Journal of Human Lactation
www.breastfeedingalwaysbest.com

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