I think it is splitting hairs to say that we are not contradicting an 
HCP when we give contradictory information to a mom. I am not trying to 
find a way around giving accurate info-I am trying to practice with 
integrity. I also do not think it is fair to the mom to expect her to 
rely on the "evidence-based" information and let it speak for itself. 
How many moms want to sit and read a treatise on mastitis when they are 
in pain. They want us to tell them how to feel better. They expect our 
educated opinions, not just some obtuse language that they have to 
interpret to decide what to do. If I am in pain and someone is giving 
me an answer and the other person is beating around the bush, what am I 
likely to choose? I cannot see how it is disrespectful to a doctor to 
disagree with him, nor how it is disrespectful to him to take good care 
of his patient. I do think, however, it is disrespectful to a mother to 
play word games with her. Remember, the doctor works for the mom and so 
do we. We all have an obligation to give the best care and the best 
information we have. It is foolish to say that we are the experts on 
breastfeeding, but that we might really be wrong and the doctor might 
be right--because he is a doctor--and well, we aren't so sure we are 
the experts after all.

As to the issue of breastfeeding and medicine--I think if we agree that 
breastfeeding is the domain of the practice of medicine, we will surely 
impose restrictions on our practice that make it much more difficult 
for women to succeed at breastfeeding. We will be more inclined to push 
breastfeeding into the world of academia, demanding degrees in 
breastfeeding in order to help women breastfeed. Breastfeeding is the 
practice of mothering and mothering is not the domain of medicine. In 
fact, all of the world is the domain of mothering and I think we need 
to allow ourselves to create a style of caregiving that is outside of 
the domain of any model we are familar with--the medical, academic or 
public health models. While all of these areas are impacted by the 
practice of mothering, the practice of mothering does not belong to 
them. This is why I believe we need to tear down the model and rebuild 
it--this is not negative or destructive, just a part of the natural 
evolution of being conscious.

Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC


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