Lynn Shea made an excellent point: while it might be momentarily
satisfying to soundly refute the preceding speaker's recommendations on
supplements, the listeners would gain more from a coherent presentation.
  Perhaps Dr. Leeper can talk with this nurse again, along the lines of
"We both have such a short time for our presentations -- let's make sure
between us that we cover the essential points."  Perhaps this nurse can
be encouraged to clarify the medical situations (with specific
symptoms/numbers etc.) that might require supplements, how to make
needed supplements less disruptive to breastfeeding, and how physicians
can help mothers follow-up with a baby who's leaving the hospital not
yet breastfeeding well.  (Perhaps a respectful conversation could be a
learning experience for this nurse.  And if she is actually set on
recommending routine supplements across the board, well, it's good to
know that too.)

The residents might be inclined to sympathize with the nurse's
experience "in the trenches" and to view a harder line on routine
supplements, however well-referenced the argument, as unrealistic.  So
it's up to the "outside" expert on lactation to acknowledge the
difficulties of dealing with a slow start to breastfeeding in that short
hospital stay, and to make the steps to head off unnecessary supplements
seem practical and sound.

Margaret Wills, LLLL, IBCLC

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