At 11:30 AM 3/31/97 -0500, you wrote:
>You are right. I should have written: "since there are so many other
>things to read, and since we all (ie mds) know that bf is best when it
>works, let's read about that mysterious new disease or that newfangled
>technology, rather than about some other virtue of bf". The problem with
>literature is that there is not so much of it concerning TREATMENT of bf
>problems. It is supposed to be natural, thus problem free, right?
Except not a majority (of mds) really believes that -- hence the
proliferation of formula -- bfing is viewed, like pain medication free
childbirth, as a "martyrdom" activity to be tolerated until the inevitable
goes wrong and the "professionals" step in.
The sad and sorry fact is that too many md's DONT as a rule think of
breastfeeding, at all. And because there isn't any new fangled high tech
neat thing to read about in terms of breastfeeding management, it's boring.
And because so much of it is an intimate dance between mother and child that
can't be quantified, medicated, tested, etc, it's annoying and a waste of time.
For
>one, I did not turn to medical journals when I started seeing bf ladies:
>I turned to lactation consultants or (rare) other physicians with
>experience.
And that is where you should turn! Good for you for getting a consult when
you were out of your league on something. LC's should be available to all!
doctors who deal with breastfeeding dyads. And they should be accorded the
same respect as any other non md therapist would (which isn't saying much
sometimes, I know).
>I also agree that mds seeing women as patients and not current in bf
>management is hair-raising. But it is a fact, and some of us have a lot
>of work to do.
>
"having a lot of work to do" is NO excuse for not being current in the
medical knowlegdge that most relates to your patients. And having a lot of
work to do does not excuse doctors from looking up the info they don't have
at their finger tips, in fact it's malpractice not to. The fact is too many
md's just don't consider lactation "important" enough to follow through on.
Would you tell a diabetic, gee sorry I don't have enough time to look up
what your postprandial glucose tolerence test results mean, just eat
whatever you want and we'll put you on insulin. Of course not! But
breastfeeding mothers are told essentially that, try it as long as the baby
gains, and don't bother me. If something goes wrong you can just use formula.
It is inexcuseable for MD's who treat women and their infants not to
have a copy of at least one good breastfeeding reference and one good drug
reference for lactating women. The "NEW BREASTFEEDING ANSWER BOOK" from La
Leche League International is set up for trouble shooting situations, you
don't have to read the whole text (though I recommend it) in order to use it
effectively for clients. And a subscription to Breastfeeding Abstracts or
Journal of Human Lactation both of which do in fact deal with solutions to
problems not just virtues of breastfeeding, are a MUST have for any MD with
breastfeeding dyads for patients. For the more serious cases, there are
plenty of other good refs. as well. Riordan and Auerbach is one that jumps
right to mind.
I'm sorry Louise, if I seem to be jumping down your throat on this, but you
are one of a very very limited minority who care enough to get any outside
information on breastfeeding, and yet you also seem have a laissez-faire
attitude about the need to be well informed. If you are this casual, and you
care, think of the 95% of physicians who don't care and the poor
breastfeeding rates in North America will make more and more sense to you.
Respectfully,
Anne E. Robb, MAT,
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