I have been reflecting some on the issue of parental guilt.
First, I really dont want to contribute to parental guilt, but can I
really do this?  I mean, my mother is convinced she is responsible for my
divorce, the success of her grandchildren in high school, etc.  How can
someone increase this kind of guilt? (G)

Second, I was personally breastfed because my mother's doctor was willing
to push her.  She went to see him when she discovered her sixth pregnancy
(me) and told him she wasn't sure she wanted to breastfeed again.  She
left his office in tears, committed to breastfeed all children she bore.
And she feels proud that she breastfed all but the last (had
life-threatening pp hemorrhage and was told she needed to recover more
than her infant needed breastmilk).  And so, this lovely man PREVENTED my
mother from having to feel guilty if I get breast cancer.  Now, he had
helped her through a birth and two miscarriages before this conversation
and he was an incredibly sensitive and insightful man.  She says he
reminded her how committed she was to providing the best for her children
and recited the benefits of breastfeeding (1959!)

Third, when someone comes in to see me for health care, they have asked
for my opinion.  If I fail to tell the truth, I have not done my job.  I
really struggle with how to present stuff about passive smoking and child
health.  This is a really tough one, since many families have a
parent(often the dad) who does not come in to see me, smokes inside the
house, and is not willing to consider changing this behavior.  I mean, am
I creating marital discord, stirring up a potentially violent situation,
or just reinforcing the woman's feeling that she cannot control the
things that matter for her child's health? Telling her that she can make
a difference by offering breastmilk to her children is empowering by
comparison.  I think timing is key.  i try to talk to women (and men)
about the benefits of breastfeeding when it isnot an immediate issue--for
example if a first born child is experiencing problems related to
artificial feeding, and I think the parent has some energy to discuss
this stuff, I bring up  the issue of the feeding choices for future
children.  I try to use an informational style, like "Lets talk about
causes of ear infections.  Some children just get them, but daycare
attendance, allergies, environmental tobacco smoke, indoor pets, and
artificial feeding can increase risk.  Have you thought about these
things? Do you think any of these things are a part of your child's
problem? Have you thought about what things you could do differently with
this child or the next one?"  I think the guilt issue comes up when we
overwhelm women with the whole stuff while she is desperately trying to
survive the transition to parenting.  That is the most difficult time to
approach this (I am not saying we shouldnt speak the truth at this time,
but that we have to be so careful then)(
Peace and Joy,

Elizabeth A. Peyton, MD,family physician, [log in to unmask]