I don't think that what (I at least) is talking about is informed consent.
It's about whether you tell women who have a condition (that cannot be
ameliorated or is being treated appropriately) or other sign that indicates
that they may have trouble making milk. I do not think that this is at all
helpful since we don't really have any way of telling what risk factors
might turn into real problems and we know that confidence is strongly linked
with breastfeeding success. Telling a woman that she may have difficulty
making milk is an intervention that we know will adversely impact her
ability to make milk. How is it OK to do that? Since perhaps 20-30% of women
report insufficient milk supply I would argue that being pregnant is a risk
factor for low milk supply. I ask again, why not tell every pregnant woman
that she has a 1 in 3 chance that she will not be able to make enough milk?
Karleen Gribble
Australia


----- Original Message ----- 
From: "Marie Davis" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Friday, July 20, 2007 5:22 AM
Subject: Re: Risk factors-to inform or not to inform


> I had to chime in on this one. Aren't we as health care providers
> responsible for informed consent?
> Our job is to go over all the variables with the mother and allow her
> to choose what she feels is best, not what we thing she should do (I
> avoid the answer to "what would you do if this were your baby?" as
> best as I can)
> We have not allowed people to remain ignorant of cigarette dangers.
> We have done our best to inform the public about the hazards of
> artificial baby milks. We should carry that forward into every thing
> we do.
> The example of starting the mother of a preemie pumping after 5 days
> of nothing is a good place to begin. First we have to educate those
> caring directly for the mom and baby in the immediate postpartum
> period the reason we have to get these moms pumping ASAP at least
> within 24 hours. It is unconscionable to let them continue telling
> moms to just start pumping and every thing will be OK. Perhaps I am
> being an idealist when I believe that if the care givers only knew
> how the body works to make milk (basic physiology) they would be less
> apt to give out such stupid information.  (OK so I AM a dreamer)
> When it comes to things I AM responsible for, I tell the truth, speak
> for the one who can't speak for himself, and really try to avoid
> embellishing a point of view that would sway her in a particular
> direction. They will not always make the right decision, a far a we
> are concerned, but hopefully they have made the right decision for
> themselves.
> Marie Davis RN. IBCLC
>
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