Hi!? Last nite I checked my mail folder at? work and tucked inside was an article from March 2, 2008 published in New York Times, written by Pamela Paul.? This article is entitled "And the Doula Makes Four".

The initial summary is that a doula can be more of a problem with some mothers and more often with physicians and nurses.? It goes on to state "similarly, lactation consultants are often necessary for mothers having difficulty breastfeeding."? The article proceeds to lump lactation consultants and doulas and their use as leading to more conflict.? Focusing on lactation consultants?who may have made recommendations like urging intravenous feeds rather than giving formula through a supplemental nursing system.? The article also stated that one couple turned to a lactation consultant for advice and "All we got was this ideological diatribe on the merits of breastfeeding", the father likened it to "It was like listening to a Marxist about an international trade deal".?? Along the?way Ms. Paul wrote that IBCLCs have increased in numbers and what the qualifications were to sit the exam, but noted that with the numbers of lactation credentials and different acronyms "How can a sleep-addled mother differentiate among a C.L.E., a C.B.E.,and a C.L.C.?"

She did sum up with a quote from Angela Love-Zaranka, IBCLC, with "People laugh when I tell them I'm going to a weeklong conference on breastfeeding, but a mother have a breast reduction surgery or a baby may have Down syndrome and you need to know how to deal with them."? And a quote from Jessica Sandler, RN, IBCLC from UCLA Medical Center who said: "I dont't deliberately think anyone is out there deliberately
trying to deceive mothers out of malice.? But parents have to do the same amount of due diligence as they would when seeking a pediatrician."

This seemed to be almost a fitting ending to my day which started out with a "Nurses' Week Breakfast" supplied by Ross.?? Urged to join in I walked by and said I would be going on to my patients.? Later I had offers of someone to go and get me something. I explained that the Code of Ethics asks me to refrain from accepting gifts from formula companies.? They said "but we got pens!"? I said "I can buy my own coffee, bagel and cream cheese and pens."? I then treated myself to a Latte Da and watched as more than half the pens didn't write and were thrown in the trash.? I did see a few LCs grab fruit or a pen and I felt that is their business, I also felt I set an example of ethical behavior for a few younger nurses...one who went a got my Latte Da and an egg.? When someone mentioned the article in my mailfolder and doulas, I said you need to exercise great care when selecting who will work with you, you need to build a team, introduce the doula to your OB let them set their parameters and discuss how they feel about issues and listen then offer your input. Remember it's your birth experience and your breastfeeding experience.? You as the parent need to make decisions...educated ones and above all be flexible.? Only anyone of us can do what we individually feels fits us best.? Desparation can lead one to make less than perfect decisions.? As the professional part of the equation we must not muddy waters, we need to help clarify information and do what is best for the patient even on some days it might include an epidural, a little oxytocin and a sprinkle of formula...but it doesn't mean bagels, cream cheese and free pens.? I thought that some of you who might have read this article? and might have a uptake on it,? I like how?the author?ended it but wish she would now?write an artlcle on ?how LCs can help and more times than not make a wonderful imprint on parents and babies inspite of all odds.

New York Times , Sunday Styles Section, page 2 March 2, 2008.

So for all of us who have to endure the gifting for Nurses' Week from the formula companies, keep the faith and Code!

Leanne Jewell RN-BC, IBCLC, LCCE, FACCE
S Florida

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