On Sat, 11 Nov 2000, Lori Salisbury, RN, IBCLC wrote:

> <<And if they die early we attribute it to a disease and not to a method of
> feeding that is ill-suited for infants>>
> I've thought about this before, and wondered if it could also be related to
> the "G" (guilt) issue.  As far as I know, HCPs don't tell parents that their
> child's illness may not have happened or might have been less severe if
> baby/child was still or had been breastfed.  Wouldn't want to make anyone who
> is grieving also feel guilty for how the baby is/was fed...  And I'm not
> saying that they should...

Lori:  I think you are right.  Most physicians I know don't even ask about
feeding status, never mind correlating the feeding status to the illness.
Actually, many don't even ask about smoking or second-hand smoke exposure
even when they see people with illnesses that are clearly related.  In our
office, we have a "problem list" in the front inside cover, in which we
list illnesses (current and previous) and risk factors.  I list smoking
there, and I also have started to list formula-feeding or early weaning
there, but I expect I am in a very small minority.  As for counselling my
patients, I really don't see it as a positive intervention to point out to
a mother that her child's asthma, or recurrent ear infections, or
........(fill in the blank), may be due to the formula-feeding or lack of
breastfeeding, except in one situation: *the mother is pregnant again*

I see this as a golden opportunity to directly link the lack of
breastfeeding to the older child(ren)'s illness and counsel her that
breastfeeding may be the one thing she can do which might lead to a better
outcome with this new baby.  In my practice, there have been a number of
mothers who heard this message and decided to breastfeed (and had much
healthier babies!). None were angry at me or said that I made them feel
guilty.  The only anger some mothers expressed was about not having been
told in the past.

One other situation where it might be helpful is the examination of an
older woman who has a diagnosis for which not breastfeeding is a risk
factor.  If she has daughters/daughters-in-law, especially if they are
pregnant, it may help to mention the importance of breastfeeding in the
hope that she will pass that on to them and be more supportive of
breastfeeding.

> Do you know if this (feeding method or breastfeeding history) is tracked in
> ongoing analysis of disease in the US or other countries?

I don't know about other countries but this is not being done in the US to
my knowledge.  IMHO, it's critically important but it may have to be
initiated from higher authorities.  I would love to hear suggestions on
implementing such a change.  Regards, Alicia Dermer, MD, IBCLC.

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