I agree with this statement that someone wrote:

>I would like doctors to order lactation consults any time a baby has problems
>related to feeding and not wait for days until the problem is severe and the
>mother's confidence has been shattered.

I think that often to the untrained eye, problems are not picked up early.
If only the people who participate in the care of these mom's, e.g. staff
nurse in hosp or doc's office, would know how to watch a feed and assess for
milk transfer, do a good history, etc there would be better assessments of
how Mom is doing. (The mother ofte does not know if there is a problem.)
Then you the doc would know when to refer. I would say that a good
precautionayr measure would be to refer anytime you are concerned about the
jaundice, anytime any supplment is recommended in the early days, anytime
Mom says her baby is not getting enough and weight gain is not 6-8 oz in 7
days, or when MOm says baby's eating all of the time and when you do a 24
hour recall of the feedings, she is nearly right,or when Mom lacks
confidence. Hmmmm. what else. I know that referrals are a precious commodity
in this day of managed care but it saves money in the long run.

I think that the family practitioners are catching on to early referrals and
I always praise for that in my follow-up note. Thanks for joining us in our
work!

Cindy
RN, IBCLC, Lansing, Michigan's Capital
MSU Grad Student