At 06:15 PM 8/10/99 PDT, you wrote:
>Rob, you're right. You can disagree, just do not say that doc is crazy!
>I just say "I disagree w/ that recommendation" or "that is not what I would
>recommend. I would recommend x and y because..."


Thank you all for permission to disagree with a doctor's recommendation
and/or premise on which it was made.  ;)

Just today a very savy mother called after going to her physician to
address her nipple yeast.  The physician said that it couldn't be yeast,
and even if it were he wouldn't prescribe fluconazole (Diflucan). Opening
and reading the authentic medical guide, the PDR, he said that if she took
one dose a day, her milk would be half and half breastmilk and Diflucan.

She said that she laughed, then caught herself and politely said that that
seemed like a high concentration, but he persisted in his claim and
repeated it. She is going elsewhere for treatment.

After we laughed about it all, she asked why could he know so little about
lactation.  I assured her that he wasn't offered much education on the
lactating breast, but a lot on breast disease.

You all know that one of the major problems here is that most OBs don't
have an on-going interest in post-natal babies and how they are fed.
Someone else should be handling lactating breast problems.  As one mother
asked, "Whom do the breasts belong to?!"  How did the OBs get stuck with
lactating breast problems anyway?

I am learning to be gentle and compassionate with them, knowing that they
don't want to be handling these lactating breast issues because they are
outside their area of expertise. And I am working to share my material with
them whenever I can.

But, addressing the current thread, I do feel obligated to give the mother
my best information and to encourage her to get a second opinion when she
sees fit.

Pat Gima, IBCLC
Milwaukee, Wisconsin, USA



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