Karen, Hope this doesn't appear to tar and feather you but, here goes:

We all know, as health care professionals, that what goes in a mother's ear
is not necessarily what came out of our mouths.  I do not think it is a good
idea to have any name calling (eg. "you are a 'bad' mother.")  Mothers may
interpret information about the risks of formula to be equivalent to calling
them bad mothers.  Think about how you would handle a mom who comes in to
your office and says her baby just doesn't like a car seat.  When the baby
is in the car seat he cries and it is so disturbing that she cannot even
enjoy herself on a drive unless she holds a baby in her arms.  Would you be
comfortable telling her that it is more important that she not feel
frustrated while in the car or that it is more important to have the child
buckled in securely, no matter how she feels about it?  If she did not
understand why, wouldn't you tell her?  If she knew how dangerous it was to
have a baby in a car without a car seat and still chose not to use the seat,
wouldn't she interpret the information you had given her as calling her a
"bad" mother?

By the same token, if a mom were smoking or drinking while pregnant,
wouldn't you expect a physician to inform the mother of the risks?  How do
you think she would feel about the person who gave her the information?
Would she interpret the information that what she was doing and will not or
cannot quit as that she was being a bad mother?

If a woman is going to have a child, she deserves to be informed about the
risks and benefits of the choices available to her.  If a mother makes a
choice that is not in the best interests of her child, she will already be
calling herself a "bad" mother.  If a mother has difficulty with having a
child in a car seat, a resposnible person will help her with coping
strategies to allow her to make the safest choice for her child.  When this
physician refers her to a lactation consultant, he is being supportive and
resposnsible.  If the physician was only giving the risks of formula and not
referring to a qualified LC then, you are right, you would be having a problem.

Personal desire really has little bearing on what is best for a baby.  A mom
is entitled to make an educated choice about feeding her baby.  If she makes
a choice that is not best for her baby, perhaps she will feel guilty.  If a
mother truly cannot (rather than will not) breastfeed, then that is
unfortunate, but I doubt there will be guilt there, although I would expect
that she would feel regret.  If a mom's breasts just don't work, there is no
place for guilt.  Just as a diabetic would not feel guilty for having to use
insulin because their pancreas do not work.  (Apologies to whoever I lifted
the analogy from. llp)  If a mom is uncomfortable with breastfeeding, she
should be given ways to cope with those feelings and minimize her
discomfort.  Perhaps this means putting her milk in a bottle, or even help
with dealing with somthing from her past.  If she cannot feed her own baby,
I do not see the guilt.  The time I see guilt is from moms who say, "If I
would have only known, I could have done something better for my child."

If you have a otherwise good relationship with this physician, how about
sitting down and talking with him.  Let him know how his words are sounding
to his clients.  Perhaps offer him a copy of the ILCA brochure "The
Lactation Consultant:  A Member of the Health Care Team."  It might help if
he wants to give copies of this when he refers clients with lacation
problems to you.

Sorry for the rambling.  You did hit a personal hot button.  I will try not
to get onto the soapbox again for a while, I did get a little dizzu up there.

All the Best,


Linda Pohl, IBCLC
Phoenix, Arizona USA
[log in to unmask]