In Reply.—Dr Roddey points out in his article and letter the urgency of early follow-up visits to the office for newborns who are being breast-fed, especially when the mother is primiparous and inexperienced. With the pressures of early discharge after delivery from the hospital, one may need to discriminate between those mothers and infants who can go home in two days and those who need further assistance under close observation, ie, in the hospital.
Considerable valuable information can be garnered from the nursery record and by observing the infant at breast in the hospital to make this decision. Anytime the weight loss exceeds 5% of the birth weight, the possible reasons should be scrutinized. In a practice in which pediatric nurse practitioners (PNPs) are available, this is an ideal role for the PNP to play. If further hospitalization is not an option, then a home visit in a