Someone posted this in another group and I thought I would share it here:
http://bfmed.wordpress.com/2010/05/01/discussions-with-doctors/
An article written by a pediatrician, Dr. Jen Thomas
Quote:
I went to San Francisco, because I never been there, in 1999 to attend an AAP meeting so that I could get some needed continuing medical education credits. One of the speakers, ABM member Dr. Nancy Wight, spoke on breastfeeding. Almost every word was news to me. Medical school, residency, chief residency and part of a neonatology fellowship and I did not know about any of the content she was presenting. One of the other speakers lectured on lice- that I knew something about. But breastfeeding? Nope. How did Dr. Wight know this stuff when I didn’t? Who taught her yet set me loose on an unsuspecting patient population armed only with my personal 7-week breastfeeding experience?
I went back home after that conference and talked my hospital’s IBCLC and asked her why she had let me get away with being so, so…wrong. I’ve learned so much since then, thanks to my colleagues at the ABM, AAP and that very patient lactation consultant.
The point is most physicians don’t ruin breastfeeding intentionally.
Sometimes, as a lactation professional (or as an informed breastfeeding mom) you have to deal with a physician who is not knowledgeable about breastfeeding. It’s a hard task if that physician isn’t receptive to your ideas, evidence-based as they may be. Those of us who are members of the ABM are often having some of the same discussions you are, and we share your frustrations.
Most physicians are “under-educated” about breastfeeding. But it’s important to know how we are educated if you are going to make a difference in how that physician responds to your attempts during teachable moments. My brother is a lawyer and often complained about the tactics of the Socratic method employed in law school where you are randomly picked to answer a question and have the potential, if you don’t know the answer, to look like an idiot in front of your classmates. Now take that Socratic method and put your client in the room, so that person, who has hired you, sees you look like an idiot too and you pretty much get the idea of medical bedside rounds. That’s how we learn. Potential public humiliation. We don’t like that.
In fact, we get very good at avoiding it. We are the doctors, taught from our first day that we are the final end point. Not knowing something is simply not acceptable. We study hard but when the answer to the question isn’t in our head, then we have to have alternate strategies. The first response is generally activation of the fight or flight response (or as in my favorite episode of “Scrubs,” the doctor with antlers strapped to his head looking into the oncoming headlights of a truck). So, we are given a topic about which we know very little and we react as if we are ready for a fight. And we weren’t taught about breastfeeding. We might be ready for a fight.
Then, we need to sound confident about whatever answer we give. (I had a friend who answered a question on rounds with “antibodies to the ovum of a sperm whale” but said the ridiculous answer with such confidence that even my attending physician, who had to know my friend was making it up, paused to think about the potential correctness of the answer.)
If we have no answer, or confident witty retort, then we start poking holes in the question or statement, asking for literature and pointing out flaws, real or perceived, in what has been presented. And we can counter every one of your stories with one of our own experiences. Starting to sound familiar? And please, never, ever underestimate the role of potential medical malpractice plays in all of this. You may be sure you are right, but the threat of legal action because of a high bilirubin or a low blood sugar that went untreated is very real. Meaning, your goals may not match those of the physician.
And, while you’re doing all that, here’s something else to think about, too: maybe you aren’t right. On my first day of medical school my Dean welcomed us by saying “Fifty percent of what we are teaching you is wrong. We just don’t know which fifty percent.”
I know it’s worth the effort, even if it’s one physician at a time. I’m not the only member of the Academy of Breastfeeding Medicine who needed the right message at the right time to hear you.
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My mother saved me from tanking my brestfeeding when my ped inisted at DS's two week checkup that he wasn't gaining enough weight and needed to have formula STAT or starve....
otherwise I would not have breastfed for the 19 mos that I did
It is also amazing how many places have no support for breast feeding moms at all. When my oldest was born 10 years ago there was no support for breast feeding. I was given a little bit of advice at the hospital and then they put my son on formula. I was pissed at the lack of support and the audacity of the nurses to do something I was against.
I was told I had to make sure my son was putting the whole areola in his mouth to get a proper latch. My second child at 31 months still could not fit my whole areola in his mouth. There was no way a 7 pound baby was going to. I spent hours on the phone with my mom 3000 miles away trying to get my son to latch on, which he was doing just fine until he was given a bottle with a preemie nipple. My mom said to only offer water in a bottle so my son wouldn't get dehydrated and keep trying to breast feed. The problem was he was starving. Once my milk came in he did just fine, but he had no desire to suckle when he wasn't getting anything.
The second and third time were much easier. I am also glad I didn't listen to anyone telling me when to stop. I had to ween my second at 31 months. I was too sick from being pregnant. I currenty have my 15 month old asking for milk so I will close this now. Go with your gut. You probably aren't wrong.
I wanted sooo badly to breast feed, and my entire family was supportive of the idea, even my daddy, but sadly i couldn't. I never developed any milk. I talked to my doctor about it and he said that not all women do develop milk, and the lactation consultant i spoke to also told me the same thing and that its ok to formula feed and not to feel discouraged or like i failed my son because i couldn't breast feed him. I know breast feeding is best, but what was best for my son was formula. DH seemed to really enjoy it, he got to feed him more often. lol so did my daddy. Daddy told me that it was ok not to breast feed, i wasn't. turns out i had the same problem my mom did.
Just out of curiosity, at what point did they determine that your milk didn't develop?
Quoting darkwhisper:I wanted sooo badly to breast feed, and my entire family was supportive of the idea, even my daddy, but sadly i couldn't. I never developed any milk. I talked to my doctor about it and he said that not all women do develop milk, and the lactation consultant i spoke to also told me the same thing and that its ok to formula feed and not to feel discouraged or like i failed my son because i couldn't breast feed him. I know breast feeding is best, but what was best for my son was formula. DH seemed to really enjoy it, he got to feed him more often. lol so did my daddy. Daddy told me that it was ok not to breast feed, i wasn't. turns out i had the same problem my mom did.
Have a child with special needs? Don't have a diagnosis? Come join other moms of special needs children without a diagnosis at my group:
www.cafemom.com/group/undiagnosed
I was lucky enough to find a hosptial and doctors that supported and were at least somewhat knowledgable in breastfeeding. However, they still wanted to cover their butts and convinced me to give my son formula to get his sugar levels up while in the hospital. They sure do know how to scare new parents! I stopped giving it to him as soon as his levels were up. But if I had known then what I know now - DS wouldn't have even had to drink that little bit he got. If it happens again (with any future kids) I'll know better - and no formula!
yep, the 'weight average charts" that doctors use are based on FF infants. BF babies tend to be leaner and denser than FF so the weights are different. 99% of doctors also know nothing about foods and herbs that help increase/promote milk supply so they never tell moms about it. In the end most moms that want to BF are sabbotaged and coerced into supplimenting or outright formula feeding. These doctors should be ashamed of themselves.
Quoting peanutsmommy1:My mother saved me from tanking my brestfeeding when my ped inisted at DS's two week checkup that he wasn't gaining enough weight and needed to have formula STAT or starve....
otherwise I would not have breastfed for the 19 mos that I did
Christian- Libertarian, NON-vaxing, Natural child birthing, Breastfeeding, Non-circumsizing, Earth- friendly, mom of One Happy, Healthy baby boy! 
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what's the best way to...
- Daynaof3
on May. 10, 2010 at 12:08 PM