What would you do if this happened to you as a PPLC

April 1, 2011

I served as a birth doula (and LC) for a mom which includes one free LC appt

postpartum. In that visit (2 days pp) I noted a few concerning things (for sake

of context those things were: posterior TT, severely damaged bleeding nipples,

sleepy baby -who was drinking the .5oz of expressed colostrum with great fervor

every 1-2 hrs.

By day three mom still had not gone in to see ped. and baby lost 11% and 2x

urin. in 24hr still passing mec. and still sleeping too much, yet mom making

even more milk, baby still drinking every drop, no jaundice, spitting up some of

the colostrum...

I gave her ways to reduce the spitting up and increase supply even further, +

drinking plenty of water, nutrition etc. told her that her options were and her

ped will also say probably to either supplement with formula if desired for 1

day or to wait until day 4 for milk to come in (as her supply still was pretty

good despite everything) but that she should see ped because the weight loss was

a bit too great and to evaluate/clip the tongue tie and assess for other issues

re spitting up.

She went to her ped that day who said finally (exactly what I said) " either you

can start on formula or wait until tomorrow when your milk will most likely come

in stronger " and also noted that tongue tie " wasn't too bad, just mild " . She

then proceeded to make her an appointment with their in-office Lactation

Consultant for follow-ups and further care.

So I basically did everything right (didn't I?) by referring and consequently

her pediatrician sort of " redirected " my client to another/their LC for future

care. She is a good Lactation Consultant around here by reputation, but so am I.

This one loss of a client isn't what bothers me as much as that it could become

a habit with that office(the biggest ped office around here). I just started my

business in this location 1 year ago and it's been a slow climb here because

there are other LC's already established in the hospitals and ped.clinics. I am

private practice so each client counts a lot.

What would you do? Talk to the other LC about it? Call the Pediatrician? Forget

about it and just let it happen? I wouldn't continue to see them as the LC

because I believe in continuity of care, the other LC should see them from now

on, just doesn't make sense to juggle care back and forth...The whole thing just

bugs me a bit.... has this ever happened to you? What did you do or what would

you do if it happened to you? suggestions most welcome please

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