>What do you do when your client, who's been working so diligently to 
>protect/build her milk supply while struggling with her infant's suck
>problems, goes in for a well baby check and to ask for a ENT referral for
>frenotomy and the Dr. tells her that "Nobody works this hard at
>breastfeeding...why don't you just give up?"

Unfortunately, there's lots of unwitting sabotage in any health concern.
I've had teen patients with BMIs of 40+ labor diligently to lose weight, and
some "helpful" family member says, "Well, you've always been fat."  I've
spent 45 minutes trying to convince a mom that her 19 month old with 2 days
of green snot doesn't need an antibiotic; she'll fire me, go across the
street, and another doctor will prescribe a Z-Pak and be out the door in 5
minutes flat.

Whenever I've been "fired" in such a situation, the following progression
runs through my head:
1) That doctor is an idiot.
2) That doctor said something idiotic.
3) That doctor said something that came across as idiotic-sounding to the
mom.
4) That doctor said something that rendered my opinion/interpretation
idiotic.
5) That doctor called me an idiot [in professional terms, of course.]
6) That mom believes *I* am an idiot now!

[In all my self-absorption here, note how I don't mention the *child's*
well-being!  I'm usually too mad at my "opponent" (since when did he become
the enemy?) and too wrapped up in licking my own wounded ego.]

So what do you do?  My humble advice is:

You take a big deep breath, congratulate mom on her fine work, try to pass
on some evidence-based medicine to the doc, KNOW in your heart that you're
right, and keep your finer feelings to yourself!

(And how different would that comment have sounded with just a few extra
words: "Nobody works this hard at breastfeeding unless they're really
committed. What's your secret for not giving up?")

Suzanne Berman, M.D., FAAP
[log in to unmask]
Plateau Pediatrics

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