Debbie: I strongly recommend that you make a written report. Use the March
issue (1995) suggestions by Beth Williams re: how to do so. Such a report
has the benefit of being able to be read and reread and each time an MD
sees a report from you, it increases his awareness that you are out there.
I have found, with my reports, that MDs often are surprised at the detail
they learn and they often askt he mothers at the next visit what they think
of me. The mothers give positive replies and 1) less unwillingness to talk
positively about breastfeeding results; followed by 2) greater willingness
to refer when problems are mentioned.  It is a slow process, but very
worthwhile. I agree that the report should go directly to the MD.  Put
"Personal and Confidential" on the evenlope if you do not intend to deliver
it personally. That will prevent staff members from opening and tossing the
information. THE MD will probably put the report in the baby's chart.

Re: the Academy for Breastfeeding Medicine. I agree that it will be
hlelpful for MDS IF the focus is on imporving medical education.  However,
I have philosophical problems with the notion that MDs can only learn from
their own.  Clearly those of you on LACTNET who are MDs do not completely
subscribe to that notion, and I for one am very pleased that you are part
of the network. Learning can occur from many people with different
backgrounds, something I very much appreciate.

PS Thank you for mentioning the Auerbach-Gartner article on jaundice. (I
bow with a pink face.)

As for references relating to frequency of breastfeeding, there are several
out there. Check the last 2-3 years of JHL for recent ones. Pay particular
attention to the Daly and Hartmann pieces in March 1995 which relate infant
frequency of feeding to maternal milk prdocution. If you need others, call
me (personally) and I will check my file. (But not this week; I am getting
ready for a conference).

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         %%  Kathleen G. Auerbach, PhD, IBCLC    %%
         %%        Lactation Services            %%
         %%        Homewood, Illinois            %%
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