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Subject:
From:
Chris Mulford RN IBCLC <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 6 Oct 1997 01:14:35 -0400
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Darlene asks for suggestions for an inservice for an OB-Gyn office.  Besides
considering the usual list of "Things we wish you knew so you could help
women breastfeed," I think you might get their attention and win points by
presenting some updated information, such as "New things we've learned about
breastfeeding in the last ten years."  This approach allows you to
1) avoid telling them DIRECTLY that they've been saying the wrong stuff, but
instead give them new information with a rationale for why you'd like them to
say different stuff;
2) treat them as intelligent professionals who will of course be interested
in hearing all the latest things from you.  You realize that they have to be
generalists in the care of women, while you have the privilege of zeroing in
on the breastfeeding and lactation literature, so you'll cover some of the
best of the recent literature and save them the trouble of looking it up for
themselves;
3) model research-based practice by discussing the practice implications of
the new info you're bringing to them;
4) build credibility by telling them things they didn't know before, in a
terrifically interesting and dynamic presentation!

Some topics that I think are neat and would consider teaching in an OB (or
pediatric) setting are:
1) the feedback inhibition of lactation (autocrine control);
2) the baby's role in determining mom's level of milk production;
3) the role of fat in influencing the baby's behavior at the breast, and thus
the volume and fat content of milk produced;
4) CCK and other gut hormones; their influence on mom's and baby's behavior;
5) the psychologic and somatic effects of oxytocin;
6) oversupply and foremilk/hindmilk imbalance; prevention, diagnosis and
treatment;
7) effect of mom's diet on baby's comfort and feeding behavior (garlic,
alcohol, intake of milk products).

These topics are all physiology-based, but I'll bet this is physiology that
these docs and nurses never learned in school!  I favor this kind of topic
because you are giving them the tools they need to solve breastfeeding
questions themselves, not just a set of rules.

One more thing.  I never met a breastfeeding advocate who wasn't capable of
talking your ear off when she or he got a chance to hold forth.  (This
statement includes me!)   We have to remember to exercise restraint.  You
want them to ask you back!  So leave 'em wanting more!  Pick about three
topics to cover in one hour; cover them well, with visuals and models and
hand-outs and whatever other wide-spectrum teaching aids you can come up
with.  Leave time for questions.  If you get a good response, mention some
other things you wish you'd had time to tell them, and see whether they ask
you back.

Good luck!     Chris

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